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多维预测模型在女性盆腔器官脱垂术后复发中的应用

The Application of a Multidimensional Prediction Model in the Recurrence of Female Pelvic Organ Prolapse after Surgery.

作者信息

Zhang Ruirui, Wang Liming, Shao Yawei

机构信息

Department of Gynecology, Suzhou Ninth People's Hospital, Suzhou, 215200 Jiangsu, China.

出版信息

Appl Bionics Biomech. 2022 Aug 12;2022:3077691. doi: 10.1155/2022/3077691. eCollection 2022.

Abstract

OBJECTIVE

The relationship between multiple indicators of women and postoperative recurrence of pelvic organ prolapse was analyzed to establish a model for predicting postoperative recurrence of female pelvic organ prolapse.

METHODS

Three hundred patients with pelvic organ prolapse who underwent pelvic organ prolapse surgery at our hospital were monitored for 1-2 years to determine their prognosis. Whether there was a postoperative recurrence, they were divided into two groups. We collected the relevant data from the two groups of patients before and after surgery. Through single factor and logistic multivariate analysis, we selected the risk factors that may affect the recurrence of patients to construct a prediction model. We verified the identification ability, proofreading ability, and clinical applicability of the model.

RESULTS

Eighty-four patients with pelvic organ prolapse who had postoperative recurrence were assigned to the recurrence group, and 216 patients were included in the nonrecurrence group. Based on the logistic multivariate analysis results, we constructed a nomogram model containing 5 dimensions of age, BMI, degree of prolapse, pubic fissure, and serum calcium to predict postoperative recurrence. The tests revealed that the model had an excellent identification ability (AUC = 0.910), and the expected recurrence rate was significantly in agreement with the actual recurrence rate ( = -0.007, Brief = 0.087). The Hosmer-Lemeshow goodness-of-fit test demonstrated that the model had good calibration (2 = 29.352, = 0.522), and the decision curve showed that the threshold probability was in the range of ~12% to 100%, having a high net benefit value.

CONCLUSION

Based on the present study findings, we concluded that the constructed nomogram model has suitable identification, calibration, and clinical applicability.

摘要

目的

分析女性多项指标与盆腔器官脱垂术后复发的关系,建立女性盆腔器官脱垂术后复发的预测模型。

方法

对我院300例行盆腔器官脱垂手术的患者进行1 - 2年的随访,以确定其预后情况。根据术后是否复发,将患者分为两组。收集两组患者手术前后的相关资料。通过单因素及logistic多因素分析,筛选出可能影响患者复发的危险因素,构建预测模型。并对模型的判别能力、校准能力及临床适用性进行验证。

结果

84例盆腔器官脱垂术后复发患者纳入复发组,216例未复发患者纳入非复发组。根据logistic多因素分析结果,构建了包含年龄、BMI、脱垂程度、耻骨弓及血清钙5个维度的列线图模型,用于预测术后复发情况。检验结果显示,该模型具有良好的判别能力(AUC = 0.910),预期复发率与实际复发率显著一致(=-0.007,Brief = 0.087)。Hosmer-Lemeshow拟合优度检验表明该模型具有良好的校准能力(2 = 29.352, = 0.522),决策曲线显示阈值概率在~12%至100%范围内,净效益值较高。

结论

基于本研究结果,我们得出结论,所构建的列线图模型具有合适的判别、校准及临床适用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5aee/9391169/15a9000a27b6/ABB2022-3077691.001.jpg

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