Risk factors analysis and risk warning model of bladder spasm after transurethral resection of prostate in elderly frail patients
Objective To investigate the risk factors of bladder spasm(BS)after electro-prostatectomy(TURP)in elderly patients,and to analyze and establish a predictive risk early warning model.Methods A total of 125 elderly patients with benign prostatic hyperplasia(BPH)in Suixi County Hospital from January 2021 to July 2023 were selected as the study subjects retrospectively.All patients underwent TURP.According to whether bladder spasm occurred during the postoperative period,they were divided into spasm group(n=30)and non-spasm group(n=95)to explore the risk factors affecting postoperative bladder spasm.Univariate and multivariate logistic regression were used to construct a predictive risk model.The receiver operating curve(ROC)and Homster-Lemeshow goodness-of-fit test(H-L)were used to evaluate the performance of the model.The clinical data of 50 patients were selected for external validation of the model.Results The probability of bladder spasm after TURP in 125 elderly BPH patients was 24.00%.The result of univariate analysis showed that in both groups,VAS score,postoperative indwelling catheter time,unstable bladder,ureteral balloon filling volume,temperature of flushing fluid,poor drainage,and postoperative constipation were statistically significant in the occurrence of BS(t=5.058,3.613,χ2=14.214,13.697,14.803,10.201,9.868,P<0.05).According to the result logistic multivariate analysis,high VAS score,long time of indwelling catheter after operation,unstable bladder,40 ml of water injection volume of catheter balloon,<30℃of flushing fluid temperature,poor drainage and postoperative constipation were independent risk factors for bladder spasm after TURP in elderly patients.H-L test result showed that χ2=2.222,P>0.05.The ROC curve showed that the area under the ROC curve(AUC)was 0.964(P<0.05,95%CI= 0.931～0.996),the sensitivity was 96.70%,the specificity was 83.00%,and the maximum Youden index was 0.83.The H-L test result of external validation showed that χ2=7.191,P=0.516.The AUC was 0.812(P<0.05,95%CI=0.695～0.929),the sensitivity was 76.70%,the specificity was 75.00%,and the maximum Youden index was 0.517.The internal and external model fitting is basically good.Conclusion The model constructed in this study has a good predictive effect on bladder spasm after TURP in elderly patients,which can provide reference for medical staff to take preventive measures in time for patients with high risk of bladder spasm after TURP.
Elderly patientsTransurethral resection of the prostateBladder spasmRisk factorsRisk warning model
NETL
NSTL
万方数据
