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《广州医药》编辑部
目的 构建与验证回肠造口术后造口周围皮炎发生的列线图预测模型。方法 回顾性分析广州市中山大学附属第六医院2022年7月—2023年7月收治的441例回肠造口术患者资料。通过单因素Logistic回归确定影响因素,基于训练队列建立列线图模型,并采用受试者操作特征(ROC)曲线和校准曲线分别评估模型的区分度与校准能力,同时通过决策曲线分析(DCA)评估临床实用性。在内部验证队列进行模型性能验证。结果 单因素Logistic回归确定6个危险因素,最终选取其中5个(是否糖尿病、造口定位、是否接受造口护理宣教、造口皮肤凹陷、性别)构建预测模型。训练队列中,模型校准曲线显示良好拟合优度(Hosmer and Lemeshow检验P = 0.976),ROC曲线下面积为0.672;决策曲线证实模型具有临床应用价值,预测模型在验证集上有类似结果。结论 本研究建立的5参数列线图模型具有良好的区分度、校准能力和临床实用价值,可为造口周围皮炎的预测提供量化工具。
Objective To establish a predictive nomogram for peristomal dermatitis after ileostomy.Methods This study analyzed 441 patients who underwent ileostomy at a third-class premium hospital.The risk factors of peristomal dermatitis were determined by univariate binary Logistics regression.Then a predictive nomogram was established with the risk factors in the training cohort.The discrimination and calibration ability of the nomogram was demonstrated by receiver operating characteristic curves and calibration curves,respectively.Besides,a testing cohort was utilized to validate the nomogram model.To reflect the clinical utility of the model,we also performed decision curve analysis.Results A total of six parameters was determined as the risk factors of peristomal dermatitis.Finally,five of them(whether diabetes,stoma location,whether to receive stoma care education,stoma skin depression,gender)were chosen to establish the nomogram.The calibration curve showed favorable calibration ability in the training cohort with a Hosmer and Lemeshow goodness of fit test P-value of 0.976 and the area under the curve of the nomogram is 0.672.The decision curve showed nomogram had potential clinical utility.These results were consistent with the testing cohort.Conclusions The nomogram established by five parameters was capable of predicting the occurrence of peristomal dermatitis with favorable discrimination and calibration ability and shows potential clinical utility.