基于列线图构建宫颈癌患者根治术后尿路感染预测模型OACSTPCD
A prediction model of urinary tract infection after radical resection of cervical cancer patients was constructed based on the nomogram
目的:基于列线图构建宫颈癌患者根治术后尿路感染预测模型.方法:选取2020 年3 月至2023 年4 月在绍兴市柯桥区妇幼保健院妇科接受治疗的189 例宫颈癌患者,按7∶3 分为模型样本(133 例)和验证样本(56 例).两样本均根据术后是否发生尿路感染分为感染组和未感染组.使用多因素logistic回归分析尿路感染的影响因素并构建宫颈癌患者感染的风险预测模型,以 ROC 曲线判断模型准确度,并通过 Hosmer-Lemeshow检验评价该模型的拟合度.结果:感染组 28 例(21.05%),未感染组 105 例(78.95%).多因素分析结果显示,两组患者术后尿潴留(OR=27.827,95%CI为 1.072～722.197,P=0.045)、降钙素原(PCT)(OR=12.640,95%CI 为 1.745～91.558,P=0.012)、肿瘤坏死因子-α(TNF-α)(OR=1.759,95%CI为1.247～2.482,P=0.001)及白细胞介素-1β(IL-1β)(OR=5.868,95%CI为1.124～30.624,P=0.036)为宫颈癌患者尿路感染的独立影响因素(均P＜0.05),在此基础上建立风险预测模型.模型公式:Logit(P)=-20.608-3.326×术后尿潴留+2.537×PCT+0.565×TNF-α+1.770×IL-1β.其ROC曲线下面积为0.990,95%CI为0.978～1.000,敏感度为 0.964,特异度为 0.933,Youden指数为0.879.风险预测模型Hosemer-Lemeshow检验显示χ2=4.167,P=0.842.结论:基于列线图模型构建的宫颈癌患者尿路感染预测模型的预测效能良好,医护人员可通过宫颈癌患者术后尿潴留及PCT、TNF-α及IL-1β等指标判断宫颈癌患者根治术后尿路感染的风险并采取针对性干预方案.
Objective:A prediction model of urinary tract infection after radical resec-tion of cervical cancer patients was constructed based on the nomogram.Methods:A total of 189 patients with cervical cancer who were treated in the Department of Gynecology,Keqiao District Maternal and Child Health Hospital of Shaoxing City from March 2020 to April 2023 were retrospectively selected as the research objects.They were divided into model samples(133 cases)and validation samples(56 cases)at a ratio of 7∶3.Both samples were divided into infected group and uninfected group according to whether urinary tract infection occurred after operation.Multivariate logistic regression was used to analyze the influencing factors of urinary tract infection and to construct a risk prediction model for infection in patients with cervical cancer.The accuracy of the model was judged by ROC curve,and the fitting degree of the model was evaluated by Hosmer-Lemeshow test.Results:There were 28 cases(21.05%)in the infec-ted group and 105 cases(78.95%)in the uninfected group.The results of multivariate analysis showed postoperative urinary retention(OR=27.827,95%CI=1.072～722.197,P=0.045),procalcitonin(PCT)(OR=12.640,95%CI=1.745～91.558,P=0.012),tumor necrosis fac-tor-α(TNF-α)(OR=1.759,95%CI=1.247～2.482,P=0.001)and interleukin-1β(IL-1β)(OR=5.868,95%CI=1.124～30.624,P=0.036)were independent influencing factors of u-rinary tract infection in patients with cervical cancer(all P＜0.05).On this basis,a risk predic-tion model was established.Model formula:Logit(P)=-20.608-3.326×postoperative urinary retention+2.537×PCT+0.565×TNF-α+1.770×IL-1β.The area under the ROC curve was 0.990,95%CI:0.978～1.000,the sensitivity was 0.964,the specificity was 0.933,and the Youden index was 0.879.Hosemer-Lemeshow test showed χ2=4.167,P=0.842.Conclusion:The predictive model of urinary tract infection in patients with cervical cancer based on the no-mogram model has good predictive performance.Medical staff can judge the risk of urinary tract infection in patients with cervical cancer after radical resection of cervical cancer by indicators such as urinary retention,PCT,TNF-α and IL-1β,and take targeted intervention programs.
李盈盈;金小青;周夫群;常艳
绍兴市柯桥区妇幼保健院,绍兴 312030温州医科大学附属第二医院,温州 325000
临床医学
列线图宫颈癌术后尿路感染预测模型
NomogramCervical cancerPostoperative urinary tract infectionPredic-tion model
《现代妇产科进展》 2024 (009)
675-678 / 4
绍兴市柯桥区科技计划项目(No:2021KZ61)
评论