Construction and Evaluation of a Predictive Model for Postoperative Abdominal Infection After Laparoscopic Treat-ment of Benign and Malignant Diseases of the Liver
Construction and Evaluation of a Predictive Model for Postoperative Abdominal Infection After Laparoscopic Treat-ment of Benign and Malignant Diseases of the Liver
Objective To explore the risk factors of postoperative abdominal infection after laparoscopic treatment of be-nign and malignant diseases of the liver,and to establish a prediction model of column line diagram and validate it.Methods The clinical data of 190 patients who underwent laparoscopic treatment of benign and malignant diseases of the liver in the depart-ment of hepatobiliary surgery,the Second People's Hospital of Neijiang,were retrospectively collected from April 2017 to April 2022 to establish a training set,and all patients were categorized into an infected group(n=30)and a non-infected group(n=160)according to whether or not they developed abdominal infection in the postoperative period.The general data,hematological indexes,and surgery-related indexes of all patients were analyzed,and the independent risk factors for postoperative complications of infection were explored by univariate analysis and multifactorial logistic regression analysis to establish a risk prediction model,and the predictive efficacy of the model was evaluated by ROC curves.In addition,the clinical data of 74 patients who underwent laparoscopic treatment for benign and malignant diseases of the liver from May 2022 to July 2023 were collected to establish a vali-dation set.The validation of the column-line graph prediction model was performed.Results A total of 30 postoperative abdomi-nal infections occurred in 190 patients with benign and malignant diseases of the liver treated by laparoscopy,including 4 cases of hepatic cysts,4 cases of hepatic hemangiomas,1 case of focal nodular hyperplasia of the liver,and 21 cases of primary hepatocel-lular carcinoma.Multifactorial logistic regression analysis showed that albumin,drain placement time,and intraoperative bleeding were independent risk factors for postoperative abdominal infection after laparoscopic treatment of benign and malignant diseases of the liver(P＜0.05),and a risk prediction model was constructed on the basis of the above three independent risk factors.The ROC curves were plotted,and the results showed that the area under the ROC curve for the training set was 0.876(95％CI 0.822～0.930),the Youden index was 0.644,the sensitivity was 0.800,and the specificity was 0.844,and the area under the ROC curve for the validation set was 0.950(95％CI 0.883～1.000),which indicated that the predictive efficacy of the model was good.Conclusion The prediction model based on albumin,plasma drain placement time,and intraoperative bleeding volume has good predictive efficacy,and is of good reference value for early identification of patients at high risk of abdominal infection.
关键词
肝脏疾病/腹腔镜手术/腹腔感染/风险预测模型
Key words
liver disease/laparoscopic surgery/abdominal infection/risk prediction model
维普
万方数据