王玥 1郭军威 2袁航 2杜磊 1贾许杨 1卜乐 2卢列盛1
作者信息
- 1. 同济大学附属第十人民医院代谢外科,上海 200072
- 2. 同济大学附属第十人民医院肥胖症诊疗中心,上海 200072
- 折叠
摘要
Abstract
Objective To investigate the high-risk factors associated with acute postoperative hypertension(APH)following laparoscopic sleeve gastrectomy(LSG)in obese patients and to establish a predictive model.Methods A retrospective analysis was conducted on clinical data and laboratory parameters of obese patients who underwent LSG at Department of Metabolic Surgery in our hospital from August 2021 to December 2023.Logistic-LASSO regression analysis was used to identify independent risk factors for APH.A nomogram predictive model was developed based on these factors.The predictive performance and clinical utility of the model were assessed using the receiver operating characteristic(ROC)curve,Bootstrap resampling,calibration curve,Hosmer-Lemeshow(H-L)test,decision curve analysis(DCA),and clinical impact curve(CIC).Results The incidence of APH was 55.90%.Body mass index(BMI),platelet count,globulin,uric acid,sodium,fibrinogen,fasting blood glucose,and preoperative diastolic pressure had potential predictive value.Among them,BMI(OR=1.066,95%CI:1.003-1.137,P=0.046),platelet count(OR=0.994,95%CI:0.998-0.999,P=0.027),fibrinogen(OR=1.943,95%CI:1.128-3.479,P=0.02),and preoperative diastolic blood pressure(OR=0.953,95%CI:0.918-0.985,P=0.006)were identified as independent high-risk factors.The area under the curve(AUC)of the nomogram was 0.783(95%CI:0.711-0.855),with a sensitivity of 0.817 and a specificity of 0.689.The AUC based on Bootstrap resampling was 0.776(95%CI:0.702-0.849).The H-L test yielded P>0.05,and the calibration curve showed good model fit.Both DCA and CIC demonstrated favorable screening efficiency.Conclusions BMI,platelet count,fibrinogen,and preoperative diastolic blood pressure are independent high-risk factors for APH following LSG.The developed nomogram model exhibits good predictive performance and clinical applicability,providing a valuable tool for early screening and prevention of APH in LSG patients.关键词
腹腔镜胃袖状切除术/急性高血压/危险因素/列线图Key words
Laparoscopic sleeve gastrectomy(LSG)/Acute hypertension/Risk factor/Nomogram分类
医药卫生
