Prediction model establishment and validation of prolonged recovery time in patients undergoing laparoscopic radical resection for colorectal cancer
Objective To investigate the influencing factors of prolonged recovery time in pa-tients undergoing laparoscopic radical resection for colorectal cancer,constructing and valida-ting a prediction model.Methods Retrospective analysis of medical records of 120 patients who underwent laparoscopic radical resection for colorectal cancer at the Second People's Hos-pital of Hefei from January 2021 to June 2023.According to the 80/20 rule,patients were ran-domly divided into training set(96 cases)and validation set(24 cases).Patients were classi-fied into prolonged recovery time group(58 cases)and normal recovery time group(38 cases)based on postoperative anesthesia recovery time.Risk factors for prolonged recovery time in pa-tients undergoing laparoscopic radical resection for colorectal cancer were screened,and a risk prediction model was constructed and validated.Results Among the 96 patients who under-went laparoscopic radical resection for colorectal cancer,38 cases(39.58%)had prolonged postoperative anesthesia recovery time,while 58 cases(60.42%)had a normal recovery time.The proportion of patients with comorbid chronic obstructive pulmonary disease,the use of in-travenous general anesthesia during surgery,the use of opioid analgesics during surgery,and the occurrence of postoperative hypoxemia were higher in the prolonged recovery group com-pared with the normal group(P<0.05).Age(OR=3.861,95%CI:1.358～10.981),co-morbid chronic obstructive pulmonary disease(OR=4.080,95%CI:1.435～11.601),in-travenous general anesthesia(OR=3.892,95%CI:1.369～11.069),opioid analgesics(OR=4.267,95%CI:1.501～12.136),and postoperative hypoxemia(OR=3.655,95%CI:1.285～10.393)were identified as risk factors for prolonged anesthesia recovery time in pa-tients undergoing laparoscopic radical resection for colorectal cancer(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the sensitivity of the Logistic regres-sion model in predicting prolonged recovery time was 0.783(95%CI:0.701～0.843),speci-ficity was0.800(95%CI:0.716～0.881),and the area under the curve was 0.821(95%CI:0.729～0.903).The sensitivity of the Logistic regression model in predicting prolonged recovery time with inflammatory markers was 0.773(95%CI:0.702～0.839),specificity was 0.794(95%CI:0.709～0.861),and the area under the curve was0.806(95%CI:0.721～0.906).Conclusion Age,comorbid chronic obstructive pulmonary disease,intravenous gen-eral anesthesia,opioid analgesics,and postoperative hypoxemia are associated with prolonged anesthesia recovery time in patients undergoing laparoscopic radical resection for colorectal cancer.The construction of a risk prediction model can help in the early screening of patients at risk of prolonged anesthesia recovery time after surgery.
colorectal cancerlaparoscopic surgeryanesthesiapostoperative recoveryinflu-encing factorsprediction model
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