Objective:To construct a nomogram prediction model for complications after laparoscopic transabdominal preperito-neal(TAPP)hernia repair in elderly patients with inguinal hernia.Methods:The perioperative data of 254 elderly patients with ingui-nal hernia who underwent TAPP from Jan.2021 to Jan.2023 were retrospectively analyzed,and the patients were followed up for at least 6 months.Binary logistic regression analysis was used to explore the independent risk factors,by which visual nomogram model was con-structed.Receiver operating characteristic curve was used to evaluate the discrimination of the model,calibration chart was used to eva-luate the calibration of the model,and the clinical decision curve was drawn to analyze the clinical ability of obtaining benefit.Results:All254 patients were followedup,andcomplicationsoccurredin33 patients,withanincidenceof12.99%.Univariateanalysisshowed that BMI,diameter of hernia sac,irreducible hernia,degree of hernia ring adhesion and intraoperative blood loss were associated with postoperative complications(P<0.05).Binary logistic regression analysis showed that BMI>24 kg/m2,hernia sac diameter>5 cm,irreducible hernia,severe adhesion of hernia ring,and intraoperative blood loss>10 mL were independent risk factors for postoperative complications.The nomogram prediction model was constructed,the area under the receiver operating characteristic curve was 0.845,95%CI=0.781～0.910,Youden index was 0.755,sensitivity was 0.879,specificity was 0.876,the model had high predictive value.The calibration curve showed that the predictive value was close to the ideal curve,and there was good consistency.The clinical decision curve showed that the model had good clinical efficacy.Conclusions:The nomogram prediction model constructed by risk factors has high discrimination and calibration,which is helpful for clinicians in preoperative evaluation and intraoperative operation,so as to pre-vent and treat high-risk patients as soon as possible.
关键词
疝,腹股沟/腹腔镜检查/老年人/手术后并发症/危险因素/列线图/预测模型
Key words
Hernia,inguinal/Laparoscopy/Aged/Postoperative complications/Risk factors/Nomograms/Prediction model
维普
万方数据