BMC Surgery最新文献

{"title":"Risk prediction models for complications after flap repair surgery: a systematic review and meta-analysis.","authors":"Jiebin Yang, Xinya Qin, Lili Hou, Yamei Liu","doi":"10.1186/s12893-025-03072-8","DOIUrl":"https://doi.org/10.1186/s12893-025-03072-8","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the performance and applicability of risk prediction models for complications after flap repair and to provide guidance for building and refining models.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, the Cochrane Library, CNKI, SinoMed, VIP and Wanfang were searched for studies on risk prediction models for flap complications. The search period is from inception to December 28, 2024. The PROBAST tool was used to evaluate the quality of the prediction model research, and Stata 18 software was employed to meta-analyze the predictors of the models.</p><p><strong>Results: </strong>A total of 16 studies were included, 28 risk prediction models were constructed, and the area under the receiver operating characteristic curve (AUC) ranged from 0.655 to 0.964, with 16 prediction models performing well (AUC > 0.7). Eleven articles underwent model calibration, 16 were validated internally, and 3 were validated externally. The results of the PROBAST review revealed that all 16 studies were at high risk of bias. The incidence rate of flap complications was 14.8% (95% CI, 10.7 - 19.0%). Body mass index (BMI), smoking history, long flap reconstruction time, diabetes mellitus, hypertension, and postoperative infection were independent risk factors for complications after flap repair (P < 0.05).</p><p><strong>Conclusion: </strong>The risk prediction model for complications after flap repair has certain predictive value, but the overall risk of bias is high, and there is a lack of external validation; thus, it needs to be further enhanced and optimized to increase its prediction accuracy and clinical practicability.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"398"},"PeriodicalIF":1.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TiRobot-assisted percutaneous vertebroplasty in the management of middle and upper thoracic osteoporotic vertebral compression fracture.","authors":"Juyi Lai, Huangsheng Tan, Pengwei Deng, Yinbo Wang, Yong Huang, Hualong Feng, Zhiming Lan, Zhitao Sun, Jian Wang, Yuanfei Fu, Shenghua He","doi":"10.1186/s12893-025-03049-7","DOIUrl":"https://doi.org/10.1186/s12893-025-03049-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the clinical efficacy and safety of TiRobot-assisted PVP surgery in the treatment of middle and upper thoracic OVCF. We also aimed to determine (1) changes in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) before and after treatment, (2) imaging changes of the fractured vertebra, (3) operation time and intraoperative blood loss, (4) frequency of puncture and fluoroscopy, hospital stay, radiation exposure of patient and surgeon, and (5) bone cement leakage and distribution and operation-related complications.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 62 patients with OVCF of the middle and upper thoracic vertebrae (T1-T8) who underwent PVP surgery in Shenzhen Traditional Chinese Medicine Hospital from January 2017 to January 2023. Of them, 30 and 32 patients underwent TiRobot-assisted PVP surgery (robot group) and conventional C-arm-assisted PVP surgery (conventional group), respectively. VAS and ODI scores and the anterior height and local kyphotic angle of the fractured vertebra were compared before surgery and 3 days, 1 month, and 1 year after surgery. Simultaneously, the operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, cement distribution, and complication were compared between the two groups.</p><p><strong>Results: </strong>VAS score and ODI score at 3 days, 1 month, and 1 year after surgery were significantly improved in both groups compared with those before surgery (p < 0.05). The VAS score of the robot group was lower than that of the conventional group 3 days after surgery (p < 0.05), with no significant difference observed before and after surgery (p > 0.05). No significant difference was observed in anterior height and local kyphotic angle of fractured vertebra between the two groups before and after the surgery (p > 0.05). The operation time, intraoperative blood loss, puncture frequency, fluoroscopy frequency, hospital stay, surgeon radiation exposure, patient radiation exposure, bone cement leakage, and cement distribution of the robot group were all better than those of the conventional group (p < 0.05). Simultaneously, the incidence of complications in the robot group was 3.33% (1/30) lower than that of the conventional group (15.62%) (5/32) (p < 0.05).</p><p><strong>Conclusions: </strong>Compared with traditional PVP surgery, the use of TiRobot-assisted PVP in the treatment of middle and upper thoracic OVCF has the advantages of accuracy, safety, and low-radiation exposure, which can further improve surgical safety, reduce bone cement leakage, and achieve satisfactory clinical efficacy.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"395"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of prehabilitation strategies on psychological state, glucose metabolism, and postoperative outcomes in patients undergoing laparoscopic sleeve gastrectomy.","authors":"Yan Zhang, Bingquan Gao, Xiaocheng Zhang, Linru Zhao, Xu Han, Miaomiao Zhang, Guihua Zhang","doi":"10.1186/s12893-025-02973-y","DOIUrl":"10.1186/s12893-025-02973-y","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the effects of prehabilitation strategies on the psychological state and glucose metabolism markers in patients undergoing laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>A total of 120 eligible patients undergoing elective LSG between January 2024 and December 2024 were enrolled in the study. They were randomly assigned to either the control group or the observation group, with 60 patients in each group. The control group received routine care interventions, while the observation group received prehabilitation strategies. The outcomes were compared between the two groups, including body mass index (BMI), body fat percentage (PBF), visceral fat area (VFA), waist-to-hip ratio (WHR), basal metabolic rate (BMR), glucose metabolism markers, psychological state, and incidence of postoperative complications, measured both one day before and six months after the intervention.</p><p><strong>Results: </strong>One day before the intervention, there were no significant differences between the two groups in BMI, PBF, VFA, WHR, and BMR (P > 0.05). However, six months after the intervention, the observation group showed significantly lower BMI, PBF, VFA, WHR, and BMR compared to the control group (P < 0.05). Furthermore, at six months post-surgery, the observation group had significantly lower HbA1c levels compared to the control group (P < 0.05), while the difference in fasting blood glucose (FBG) was not statistically significant (P > 0.05). Regarding psychological state, the observation group showed significantly lower scores on the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) six months after the intervention (P < 0.05). Additionally, the incidence of postoperative minor complications was significantly lower in the observation group compared to the control group (P < 0.05).</p><p><strong>Conclusion: </strong>Prehabilitation strategies can effectively improve the psychological state, reduce glycated hemoglobin levels, promote weight loss, and reduce the incidence of minor postoperative minor complications in patients undergoing laparoscopic sleeve gastrectomy. These strategies appear to be safe and effective, and could be considered for wider clinical adoption.</p><p><strong>Clinical registration number: </strong>Not applicable.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"394"},"PeriodicalIF":1.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12379387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world safety of irreversible electroporation therapy for tumors with nanoknife: MAUDE database analysis.","authors":"Jia-Cheng Xiang, Zhi-Yu Xia, Jian-Xuan Sun, Shao-Gang Wang, Qi-Dong Xia","doi":"10.1186/s12893-025-03136-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03136-9","url":null,"abstract":"<p><strong>Background: </strong>Irreversible electroporation (IRE) is a non-thermal ablation technique using high-voltage, low-energy pulses to induce cell membrane perforation and cell death. As an emerging therapy, IRE has gained increasing application in local tumor treatment, with Nanoknife being the most widely used device. Despite its relative safety compared to traditional therapies, potential adverse reactions still merit the attention of clinicians.</p><p><strong>Methods: </strong>We analyzed all IRE-related adverse event reports in the Manufacturer and User Facility Device Experience (MAUDE) database, focusing on event types, Clavien-Dindo Grades, the timing of adverse events and temporal trends across cancers.</p><p><strong>Results: </strong>Device malfunctions with Nanoknife were a significant issue but have declined recently. In pancreatic cancer, gastrointestinal injuries (mainly hemorrhagic lesions) were most commonly reported. In liver cancer, arrhythmias were frequent, with no new cases in recent years. In prostate cancer, rectal fistula was the most common adverse event, with an increasing number of cases being reported.</p><p><strong>Conclusions: </strong>Theoretically, the Nanoknife is expected to exhibit favorable safety profiles. However, ongoing attention to device maintenance, treatment standardization, and postoperative management is needed to further enhance its safety.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"390"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous Port implantation in persistent left superior vena cava with azygos vein variation: a case report and literature review.","authors":"Li Zhang, Jingjin Wu","doi":"10.1186/s12893-025-03144-9","DOIUrl":"https://doi.org/10.1186/s12893-025-03144-9","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"389"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of surgical care pathways on efficiency and outcomes in orthopedic operating rooms: a historical control study.","authors":"Tao He, Xiaojun Zhu, Guanghao Chi, Huan Chen, Min Hao, Xin Huang, Guanrong Wang","doi":"10.1186/s12893-025-03135-w","DOIUrl":"https://doi.org/10.1186/s12893-025-03135-w","url":null,"abstract":"<p><strong>Objective: </strong>The impact of surgical care pathways (CP) on efficiency and patient outcomes in orthopedic operating rooms (OR) is unclear, and we aim to optimize nursing strategies and enhance service quality.</p><p><strong>Methods: </strong>From July 2019 to June 2024, 3,836 patients undergoing orthopedic surgery at a single Grade 3 Chinese hospital were retrospectively analyzed and divided into two equal groups, with or without CP (1,918 patients in each group). The effectiveness of CP was assessed by comparing surgical site infection (SSI) rates, pathogens, OR turnover times, and patient satisfaction. Statistical analyses included between-group comparisons and multivariate logistic regressions.</p><p><strong>Results: </strong>Baseline characteristics were balanced across groups (SMD < 0.1). Overall SSI rates were 2.1%, significantly lower in the CP group than in the Non-CP group (1.6% vs. 2.6%, P < 0.05), and translating to a 43% risk reduction (OR 0.57, 95% CI: 0.36-0.88, P < 0.05). Gram-positive bacterial infections notably decreased (OR 0.331, 95% CI: 0.093-0.959, P < 0.05). CP implementation also improved OR turnover times (95% CI: 0.504-0.839, P < 0.001) and patient satisfaction (95% CI: 1.038-2.301, P < 0.05). No significant differences were observed in other nursing quality indicators.</p><p><strong>Conclusion: </strong>Standardized CPs are effective in significantly reducing the incidence of postoperative SSIs, particularly those caused by Gram-positive bacteria, thereby enhancing infection control. Furthermore, these pathways improve OR operational efficiency and patient satisfaction, supporting reforms in OR management practices.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"392"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy analysis of one-stage posterior debridement, bone graft fusion, and internal fixation for the treatment of lumbar brucellosis spondylitis.","authors":"Yanchuan Yang, Xiaojun Ma","doi":"10.1186/s12893-025-03143-w","DOIUrl":"https://doi.org/10.1186/s12893-025-03143-w","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical efficacy of one-stage posterior debridement with bone grafting, fusion, and internal fixation in the treatment of Brucellosis Spondylitis.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 45 patients (30 males and 15 females) with lumbar Brucellosis Spondylitis who met the inclusion criteria and were treated at the Department of Spinal Orthopedics, General Hospital of Ningxia Medical University between January 2010 and February 2025.Patients ranged in age from 30 to 74 years (mean 52.7 ± 10.4 years) and had spinal lesions involving no more than two segments between T12 and S1. All patients received strict oral anti-brucellosis medication before and after surgery, and underwent one-stage posterior debridement with bone grafting, fusion, and internal fixation. Clinical parameters including hospital stay duration, operative time, intraoperative blood loss, and postoperative drainage volume were recorded. Follow-up assessments included Visual Analog Scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores for low back pain, ASIA impairment scale for neurological function, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), standard agglutination test (SAT), kyphotic Cobb angle of the affected segments, and postoperative complications such as implant loosening or rod fracture at various time points before and after surgery.</p><p><strong>Results: </strong>All 45 patients achieved surgical site healed primarily without cerebrospinal fluid leakage or neurological complications. Within one week after the surgery, mild activities (such as standing beside the bed and short-distance walking) can be performed with the aid of a brace to promote blood circulation and prevent complications, with significant improvement in low back pain and neurological symptoms. All patients with preoperative neurological deficits recovered to ASIA grade E by 24 months postoperatively. Significant improvements (P < 0.05) were observed in mean VAS scores, JOA scores, ESR, CRP levels, and Cobb angles at all postoperative time points compared to preoperative values. At final follow-up, all patients demonstrated SAT titers below 1:160. The bone fusion rate reached 91.11% (41/45) according to Bridwell's classification criteria. Based on the modified MacNab criteria, the excellent and good rate was 95.56% (43/45). No cases of disease recurrence, implant loosening, or rod/screw breakage were observed during the follow-up period.</p><p><strong>Conclusion: </strong>For lumbar Brucellosis Spondylitis, one-stage posterior debridement with bone grafting, fusion, and internal fixation, when combined with standardized pharmacological treatment, represents an effective therapeutic approach. This comprehensive treatment strategy facilitates thorough lesion eradication, improves spinal function, and achieves satisfactory clinical outcomes.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"391"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of remote and virtual surgical training in expanding cardiothoracic surgical capacity in low-resource regions.","authors":"Achanga BillSmith Anyinkeng, Samuel Mesfin Girma, Taryim Maurice, Efuetlateh JohnPaul, Tsion Hiwot, Ahmed K Awad","doi":"10.1186/s12893-025-03142-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03142-x","url":null,"abstract":"","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"393"},"PeriodicalIF":1.8,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective study comparing three approaches for keloids: surgery + radiotherapy, surgery + pharmacological injection, and surgery alone.","authors":"ShengHua Chen, Xu Mu, Lin Zhang, Wei Liu, YuYang Han, Hanhua Li, Wen Lai, Zhifeng Huang","doi":"10.1186/s12893-025-03095-1","DOIUrl":"https://doi.org/10.1186/s12893-025-03095-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the differential efficacy of various treatment modalities adjunct to surgical excision of keloids and to analyze prognostic factors influencing outcomes.</p><p><strong>Methodology: </strong>A retrospective observational study approach was employed. Clinical data from 121 patients with keloids who met the inclusion criteria were collected for analysis of clinical characteristics and evaluation of treatment efficacy. The patients were categorized into three groups based on the adjuvant treatment modalities utilized post-surgical excision of keloids: surgical + radiotherapy group (group A), surgical + radiotherapy + pharmacological injection group (group B), and surgical group (group C). Factors potentially influencing treatment outcomes-such as treatment modality, gender, age, lesion distribution, lesion size, duration of the condition, and prior treatments-were subjected to a statistical analysis. Significant risk factors were identified through univariate analysis.</p><p><strong>Results: </strong>The efficacy rates for group A, group B, and group C were 93.88%, 87.04%, and 55.56%, respectively. Statistical analysis indicated that age and treatment modality were significant risk factors for recurrence.</p><p><strong>Conclusion: </strong>The application of radiotherapy post-surgery, or a combination of radiotherapy and pharmacological injections postoperatively, has been demonstrated to significantly reduce the recurrence rate of keloids. Conversely, the efficacy of treatments that solely rely on surgery is comparatively lower. For elderly patients, early intervention upon the manifestation of clinical symptoms is strongly advocated, with a preference for adjunctive postoperative radiotherapy to mitigate the risk of recurrence.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"386"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An easily acquirable predictive model for strangulated bowel obstruction: the BAR-N.","authors":"Cuifeng Zheng, BaoWei Xu, Pingxia Lu, Weixuan Xu, Shenhui Lin, Xianqiang Chen, Junrong Zhang, Zhengyuan Huang","doi":"10.1186/s12893-025-03045-x","DOIUrl":"https://doi.org/10.1186/s12893-025-03045-x","url":null,"abstract":"<p><strong>Background: </strong>Small bowel obstruction (SBO) is a prevalent gastrointestinal disorder that consists primarily of two types: simple bowel obstruction (SiBO) and strangulated bowel obstruction (StBO). Due to life-threatening complications such as septic shock and multiple organ dysfunction syndrome, there is an urgent need for an easy-to-acquire predictive model for StBO based on clinical symptoms and laboratory.</p><p><strong>Methods: </strong>A total of 453 patients diagnosed with SBO were randomly divided into training and validation datasets at a ratio of 7:3. The demographic, clinical, and laboratory data were collected. Least absolute shrinkage and selection operator (LASSO) regression was employed to identify relevant variables, and a multivariable logistic regression (LR) model was subsequently developed. The performance of the model was evaluated using receiver operating characteristic (ROC) curve analysis, and diagnostic metrics, including accuracy, sensitivity, specificity, and area under the curve (AUC), were calculated.</p><p><strong>Results: </strong>Of the 453 patients diagnosed with SBO, 62 (13.7%) had StBO, and 391 (86.3%) had SiBO. Univariate analysis revealed significant associations between bowel ischemia and the following variables: body mass index (BMI, p = 0.027), neutrophil percentage (N, p = 0.002), aspartate aminotransferase (AST, p = 0.024), serum creatinine (p = 0.030), serum urea (p = 0.019), glucose (p = 0.029), prothrombin time (PT, p = 0.043), cessation of defecation and flatus (p = 0.013), tenderness (p = 0.004), and rebound tenderness (p < 0.001). A LASSO regression model with optimized regularization parameters (α = 0.3, λ = 0.0202; log[λ] = - 3.902) was used to select 10 predictors. Rebound tenderness (OR, 6.64; 95% CI, 2.97-15.48; p < 0.001), BMI (OR, 0.02; 95% CI, 0.00-0.37; p = 0.010), N (OR, 1.05; 95% CI,1.01-1.09; p = 0.009), and AST (OR, 1.97; 95% CI, 1.01-4.06, p = 0.055) were significantly associated with intestinal ischemia via multivariable LR. The final predictive model (BAR-N) had a strong performance, with an AUC of 0.784 in the training cohort and 0.750 in the validation cohort. Additionally, the model exhibited high specificity (90.3%) and accuracy (80.7%), although its sensitivity remained relatively low at 31.8%.</p><p><strong>Conclusions: </strong>We developed an easy-to-acquire predictive model (BAR-N) for the diagnosis of StBO that incorporates both clinical and laboratory data. This model shows promise as an adjunctive decision-support tool, particularly in resource-limited or high-acuity settings. However, its generalizability is limited by the absence of external validation, underscoring the need for future multicenter studies to confirm its broader applicability.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"385"},"PeriodicalIF":1.8,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144976023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}