The value of constructing a postoperative prognostic model for orbital tumors based on baseline data
Objective To analyze the prognostic factors of orbital tumor resection.Methods A prospective case series study.109 patients with orbital tumor were selected for surgical resection in our hospitalwere selected from January 2020 to January 2022.All patients underwent orbital tumor removal surgery,and patients were followed up for 6 months af-ter surgery.Postoperative complications were recorded and general data of patients were collected.According to whether the patients had death,recurrence,respiratory failure,visual impairment,shock,cerebrovascular accident,cardiac ar-rest and blindness,the patients were determined to have a poor prognosis.According to the prognosis of the patients,the patients were divided into a poor prognosis group and a good prognosis group.Results Among the 109 patients,16 pa-tients had complications,with a complication rate of 14.68%,among which the highest incidence of eye movement disor-ders was 13.76%,and the incidence of postbulbar hemorrhage,dilated pupil,visual impairment and ptosis were 9.17%,7.33%,5.50%and 4.59%,respectively.Among the 109 patients,94 had good prognosis and 15 had bad prognosis.The good prognosis rate was 86.24%.Through univariate analysis,the course of disease and gender of patients in the good prog-nosis group and the poor prognosis group were similar(P>0.05).The number of cases in the poor prognosis group was higher than that in the good prognosis group(P<0.05),including deep tumor involvement,low tumor differentiation,complications,blurred tumor boundaries,traditional orbital open malignant tumor,intramuscular tumor,operation time≥3 h,age>75 years.Statistically significant factors in univariate analysis were incorporated into logistic multivariate analy-sis,and the analysis results showed that,the independent risk factors for poor prognosis were deep tumor involvement,poorly differentiated tumor differentiation,complications,blurred tumor boundaries,traditional orbital opening,malig-nant tumor,intramuscular tumor,operation time≥3 h and age≥75 years(P<0.05).The lowest β value of risk factors in logistic multivariate analysis was assigned 1,and the β value of other variables was divided by the minimum value and rounded to an integer.Among them,tumor nature and orbital opening method were 4 points,tumor involvement and tumor boundary were 3 points,tumor differentiation and complications were 2 points,and tumor site,operation time and age were 1 point.The total score is between 0 and 21.According to this model,all patients were scored and its predictive value for patients'prognosis was analyzed.It was found that the higher the score was,the higher the incidence of poor prognosis was.Among them,the incidence of poor prognosis was 100%in patients with scores 1～3 and 19～21.The receiver operat-ing characteristic(ROC)curve of the risk assessment model for the occurrence of poor prognosis after orbital extraction was drawn,with the risk score as the independent variable and the postoperative prognosis as the dependent variable.Analysis results showed that the area under ROC curve was 0.849(95%CI:0.773 to 0.936),and 13.23 was the optimal critical value,at which the prediction specificity and sensitivity were 80.3%and 85.6%,respectively.Conclusions Deep tumor involvement,poorly differentiated tumor differentiation,complications,blurred tumor boundaries,traditional or-bital opening,malignant tumor,intramuscular tumor,operation time≥3 h,and age≥75 years are independent risk fac-tors for poor prognosis of patients.The combination of the above factors to construct a prognostic model has positive signifi-cance for the prognosis of patients.Clinical attention and active intervention to the prediction model can effectively improve the prognosis of patients.
Orbital tumor excisionInfluencing factorsBaseline dataPrognosi
万方数据
维普
