Construction of a nomogram prediction model for risk factors of intestinal obstruction after radical laparoscopic prostate cancer surgery
Objective To explore the risk factors of dynamic ileus after laparoscopic radical resection of prostate cancer,and toconstruct a nomogram prediction model and to evaluate it.Methods 46 patients who underwent laparoscopic radical prostatectomy in thehospital from January 2022 to June 2023 and de-veloped dynamic intestinal obstruction after surgery were selected as case group,and 92 patients who did not experience dynamic intestinal obstruction after radical prostatectomy during the same period were se-lected as control group.Record the patient's general information,preoperative and postoperative levels of albumin,C-reactive protein(CRP),tumor necrosis factor alpha(TNF alpha)and interleukin-6(IL-6)with in 24 hours.The researchusedSelf Rating Anxiety Scale(SAS)to evaluate the patient's preoperative anxiety level and to record the score.A univariate analysis was conducted on the risk factors for postopera-tive dynamic intestinal obstruction in prostate cancer patients.Statistically significant univariate variables were included in the binary Logistic multiple regression analysis,and a column chart prediction model was constructed using R software.Results Compared with control group,the proportion of the patients in the case group with hyperlipidemia,heart disease,chronic obstructive pulmonary disease,and the use of opi-oid analgesics,surgical time,preoperative anxiety score,average increase in serum TNF-α and IL-6 levels,and decrease in postoperative albumin levels were statistically significant(P＜0.05).The results of binary multivariate Logistic regression analysis showed that heart disease(X1),use of opioid analgesics(X2),higher preoperative anxiety score(X3),lower postoperative serum albumin level(X4)and higher postop-erative serum TNF-α level(X5)and IL-6 level(X6)were independent risk factors for postoperative dy-namic intestinal obstruction in prostate cancer patients(P＜0.05).The constructed Logistic regression model was Log(P)=-14.019+1.336X1+1.622X2+0.129X3-0.145X4+0.050X5+0.072X6.The calibration curve showed good consistency of the column chart model,and the clinical decision curve evalu-ation results showed that the model had good application value.The ROC curve analysis results indicated that the area under the curve predicted by the model was 0.856(0.812～0.926),with sensitivity and spe-cificity of 75.2％and 76.1％,respectively.Conclusion Heart disease,opioid analgesics,preoperative anxiety score,postoperative albumin,TNF-α and IL-6 levels are independent risk factors for dynamic ilob-struction in patients with prostate cancer after surgery.The established nomograph model has good accu-racy and clinical application value.
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