转化医学杂志2025，Vol.14Issue(3)：89-95,7.DOI:10.3639/j.issn.2095-3097.2025.03.018
盆腔器官脱垂术后复发的Lasso-Logistic回归分析及预测模型构建
Lasso-Logistic Regression Analysis and Prediction Model Construction for Recurrence of Pelvic Organ Prolapse After Surgery
摘要
Abstract
Objective To analyze the influencing factors of recurrence after pelvic organ prolapse(POP)surgery through LASSO-logistic regression analysis and construct a predictive model.Methods Clinical data of 200 POP patients who underwent surgical treatment in Maternal and Child Health Hospital of Guangyuan from October 2018 to October 2022 were selected.Patients were divided into a recurrence group(n=41)and a non-recurrence group(n=159)based on whether they had relapsed within 2 years after surgery.The clinical data were compared between the two groups.The factors influencing the recurrence of POP after surgery were analyzed using LASSO-logistic regression.A nomogram prediction model for POP recur-rence after surgery was constructed based on the influencing factors.The application value of the nomogram prediction model was analyzed using receiver operating characteristic(ROC)curves,calibration curves,and decision curves.Results The age,body mass index(BMI),proportion of menopause,proportion of patients with a history of pelvic surgery,proportion of patients with a preoperative pelvic organ prolapse quantitative grading method(POP-Q)of Ⅲ～Ⅳ degree,proportion of patients with a hysterectomy,and proportion of patients with a postoperative chronic constipation in the recurrence group were higher than thoes in the non-recurrence group.The proportion of patients with regular postoperative rehabilitation training and regular sexual life was lower in the recurrence group than in the non-recurrence group(P<0.05).LASSO-logistic regression analysis showed that BMI,menopause,preoperative POP-Q Ⅲ-Ⅳ degree,hysterectomy,and postoperative chronic constipation were all indepen-dent risk factors for POP recurrence,while regular postoperative rehabilitation training was an independent protective factor(P<0.05).The concordance index(C-index)of the nomogram prediction model for predicting POP recurrence after surgery was 0.901,indicating high discrimination.The area under the curve(AUC)was 0.901,indicating high predictive performance.The calibration degree of the nomograph prediction model was high,and the prediction results had good consistency with the actual observation results.The nomogram prediction model had a significant positive net benefit and has high clinical utility in pre-dicting the risk of recurrence after POP surgery.Conclusion The influencing factors of POP recurrence after surgery are BMI,menopause,preoperative POP-Q grade Ⅲ-Ⅳ,hysterectomy,regular postoperative rehabilitation training,and chronic consti-pation.Constructing a nomogram prediction model based on these factors can provide reliable clinical evidence for identifying high-risk patients with recurrence.关键词
盆腔器官脱垂/手术治疗/复发/影响因素/预测模型Key words
Pelvic organ prolapse/Surgical treatment/Recurrence/Influencing factors/Prediction model分类
临床医学引用本文复制引用
申铁英,黄锦,齐建位..盆腔器官脱垂术后复发的Lasso-Logistic回归分析及预测模型构建[J].转化医学杂志,2025,14(3):89-95,7.基金项目
2023年度中医药科研专项课题(2023MS3356) （2023MS3356）
