摘要
Abstract
Objectives To analyze the risk factors affecting the quality of life(QOL)in patients with colorectal polyps af-ter endoscopic submucosal dissection(ESD)and to construct a risk evaluation system for postoperative QOL.Methods Clinical data of 660 patients who underwent ESD for colorectal polyps at the First Affiliated Hospital of Hebei North Uni-versity from March 2018 to March 2025 were included.Among them,440 patients(mean age:64.3±9.4 years;264 males and 176 females)were used to develop and internally validate the risk evaluation system,while 220 patients were used for external validation.Automatic binning analysis was applied to QOL scores to identify the group with the lowest scores.Logistic regression analysis was used to develop a risk evaluation system based on the odds ratio(OR)of independent risk factors,and its predictive performance and application value were evaluated.Results The group with the lowest QOL scores was set as the target category,with other groups as controls.Multivariate Logistic regression analysis showed that advanced age,hypertension,large polyp diameter,general anesthesia,absence of intraoperative fluid replacement,non-standard intraoperative body temperature management,non-standard postoperative pain management,non-standard postoperative medication management,and non-standard postoperative psychological support were indepen-dent risk factors for classification into the lowest QOL scores group(P＜0.05).Internal validation of the risk evaluation system showed a C-index of 0.822(95％CI,0.695 to 0.915)for predicting classification into the lowest QOL scores group.The calibration curve demonstrated good consistency,and the clinical decision curve indicated net benefit.External valida-tion results showed that the system had good receiver operating characteristic(ROC)curve fit for predicting the lowest QOL scores classification in both the 440-patient and 220-patient cohorts(x2=6.774,P＞0.05),with area under the curve(AUC)values of 0.834 and 0.828,respectively,and no statistically significant difference(P＞0.05).Conclusion The risk evaluation system enables rapid identification of patients with low QOL after ESD and facilitates accurate interven-tion strategies.Its application supports rapid patient recovery and holds significant clinical value.关键词
结直肠息肉/内镜黏膜下剥离术/生活质量/风险/评价体系Key words
colorectal polyps/endoscopic submucosal dissection/quality of life/risk/evaluation system分类
医药卫生
