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新生儿肠闭锁一期吻合术后完全肠内营养的多变量Cox回归模型。

The multivariate cox regression model for complete enteral nutrition after primary anastomosis in neonates with intestinal atresia.

作者信息

Chen Yang, Zhu Le-Dao, Zhou Ling, Guan Ai-Hui, Wang Zhi-Yong, Xiao Dong, Ma Xiao-Peng, Ren Feng

机构信息

Shenzhen Children's Hospital, Shenzhen, China.

College of Medicine, Shantou University, Shantou, China.

出版信息

Front Pediatr. 2022 Dec 12;10:1071056. doi: 10.3389/fped.2022.1071056. eCollection 2022.

Abstract

OBJECTIVE

Enteral feeding after intestinal atresia has always been a concern for clinicians. But the present studies mainly focused on single factors. This research aimed to comprehensively analyze the multiple factors on complete enteral nutrition after primary anastomosis, and establish the convenient prediction model.

METHODS

We retrospectively collected reliable information in neonates with intestinal atresia form January 2010 to June 2022. The cox regression analysis was performed to select independent risk factors and develop nomogram. Subsequently, ROC curve, calibration curve and decision curve were drawn to thoroughly evaluate the accuracy and applicability of the model.

RESULTS

The predictors finally included in the model were gestational age, meconium peritonitis, distance from the anastomosis to the ileocecal region, diameter ratio of proximal to distal bowels, and time of initial feeding. The nomogram of predicting the probability of week 2, week 3 and week 4 was drawn and their area under the curve were 0.765, 0.785 and 0.747, respectively. Similarly, calibration and decision curve indicated that the prediction model had a great prediction performance.

CONCLUSION

The clinical value of predictive models can be recognized. The hope is that the predictive model can help pediatricians reduce hospital costs and parental anxiety.

摘要

目的

肠闭锁术后的肠内喂养一直是临床医生关注的问题。但目前的研究主要集中在单一因素上。本研究旨在综合分析一期吻合术后实现完全肠内营养的多种因素,并建立便捷的预测模型。

方法

我们回顾性收集了2010年1月至2022年6月期间肠闭锁新生儿的可靠信息。进行Cox回归分析以选择独立危险因素并绘制列线图。随后,绘制ROC曲线、校准曲线和决策曲线以全面评估模型的准确性和适用性。

结果

最终纳入模型的预测因素包括胎龄、胎粪性腹膜炎、吻合口至回盲部的距离、近端与远端肠管直径比以及初次喂养时间。绘制了预测第2周、第3周和第4周概率的列线图,其曲线下面积分别为0.765、0.785和0.747。同样,校准曲线和决策曲线表明该预测模型具有良好的预测性能。

结论

预测模型的临床价值值得认可。希望该预测模型能够帮助儿科医生降低医院成本并减轻家长的焦虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5580/9791088/3de65055f9a9/fped-10-1071056-g001.jpg

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