Establishment and verification of prediction model for recurrent patients with ovarian endometriosis after laparoscopic conservative surgery
Objective To construct a clinical predictive model by analyzing the relevant factors of recurrence in patients with ovarian endometriosis(EMT)after laparoscopic conservative surgery,in order to provide recurrence screening tools and personalized treat-ment plans for patients after laparoscopic conservative surgery.Method A retrospective analysis was conducted on 470 patients who under-went laparoscopic conservative surgery and were pathologically diagnosed with EMT.According to the diagnostic criteria for recurrence,470 patients were divided into recurrence group(100 cases)and non-recurrence group(370 cases).The univariate and multivariate logistic regression analysis methods were used to screen out the key factors that lead to recurrence after conservative surgery for EMT.R language was used to construct a predictive model for postoperative recurrence after conservative surgery for EMT,and draw column charts,ROC curves,calibration charts and clinical decision curves to evaluate the predictive ability and clinical effectiveness of the model.This study used a random split method to divide 470 patients into training set(330 cases)and validation set(140 cases).Result The parity,irregu-lar menstruation,high ASRM staging,previous pelvic surgery history and concomitant adenomyosis were the relative risk factors for postoper-ative recurrence of EMT(P＜0.05).The recurrence prediction model for patients undergoing laparoscopic conservative surgery constructed in this study showed good discriminative ability in the area under the ROC curve(AUC=0.839,sensitivity 61.4％,specificity 90.4％).The calibration chart showed the consistency between the theoretical and predicted values,with a slope of approximately 1.Decision curve(DCA)decisions had certain clinical application value.Internal validation showed the lower area of the validated ROC curve(AUC=0.813,sensitivity 76.7％,specificity 78.2％).Conclusion The parity,irregular menstruation,high ASRM staging,previous pelvic surgery history and concomitant adenomyosis are independent risk factors for postoperative recurrence of EMT(P＜0.05),while the age of surgical is greater than 35 years old,postoperative pregnancy and postoperative medication are protective factors.The column chart model based on these factors can more effectively predict the recurrence of postoperative patients with endometriosis.
万方数据
维普
