Construction of a Risk Prediction Model for Early Postoperative Enteral Feeding Intolerance in Pa-tients with Upper Gastrointestinal Cancer
Objective To analyze the risk factors for early postoperative enteral feeding intolerance in patients with upper gastrointestinal cancer and construct a risk prediction model.Methods Retrospective analysis was performed on 210 patients with upper gastrointestinal cancer who were admitted to the general surgery department of a Grade Ⅱ-A hospital in Shanghai from May 2021 to December 2022.They were divided into the intolerance group(n=121)and the tolerance group(n=89)based on the incidence of early postoperative enteral feeding intolerance.Differences were compared between the two groups.The risk factors for early postoperative enteral feeding intolerance in patients with upper gastrointestinal cancer were analyzed by logistic regression.The risk prediction model was constructed based on the risk factors.Then,the calibration and discrimination of the model were evaluated based on the area under the receiver operating characteristic curve(ROC)and the Hosmer-Lemeshow(H-L)test.Results The incidence of early postoperative enteral feeding intolerance was 57.62%in patients with upper gastrointestinal cancer.Multivariate logistic regression analysis revealed several independent risk factors for early postoperative enteral feeding intolerance in patients with upper gastrointestinal cancer:1)hypoproteinemia,2)hyperglycemia,3)enteral potassium replacement,4)postoperative pain score≥4 points,and 5)ambulation 3 days after surgery.The H-L test showed that χ2 = 6.523(P=0.367),the ROC of the model was 0.916(P<0.001),the sensitivity was 0.857 and the specificity was 0.832.Conclusion The incidence of early postoperative enteral feeding intolerance is high in patients with upper gastrointestinal cancer.The risk prediction model constructed in this study exhibits good prediction performance and can assist clinical healthcare providers in identifying individuals at high risk of enteral feeding intolerance,thereby serving as a valuable reference for early nursing intervention.
Upper gastrointestinal cancerIntestinal nutritionFeeding intolerancePrediction model
万方数据
维普
