Liu Liyang, Yuan Yugang, Zeng Junhao, Zhu Ge, Su Xuehua, Gong Xingrui, Cui Cao
Department of Emergency, Renmin Hospital of Wuhan University, Wuhan, 430060, Hubei Province, China.
Department of orthopaedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, China.
Sci Rep. 2025 May 1;15(1):15289. doi: 10.1038/s41598-025-00493-6.
Postoperative constipation is often accompanied by abdominal pain, loss of appetite, nausea and vomiting, or even adverse cardiovascular and cerebrovascular events. This study aimed to establish nomogram for predicting the risk of postoperative new-onset constipation in elderly patients with hip fractures, and validate its performance. Patients who underwent hip surgery in our hospital between January 2021 and December 2023 were enrolled in this study. Univariate and multivariate logistic regression analyses were performed to identify significant factors influencing postoperative constipation. A nomogram was constructed for predicting postoperative new-onset constipation, and its discriminative, concordance, and clinical utility were examined. A total of 1,092 elderly patients were enrolled, among whom 955 without preoperative constipation were included for nomogram establishment. Multivariable logistic regression identified ten factors were associated with postoperative new-onset constipation, including body mass index, cerebrovascular disease, cardiovascular disease, gastrointestinal disease, blood loss, renal disease, preoperative lower limb thrombosis, heart surgery history, patient-controlled analgesia and preoperative pulmonary infection. A nomogram comprising these factors was constructed, and the area under the receiver operating characteristic curve for the training set and the test set were 0.730 (0.692-0.768) and 0.712 (0.651-0.772), respectively. The nomogram developed in this study showed good discriminative ability in predicting the risk of postoperative new-onset constipation in elderly patients undergoing hip fracture surgery. The proposed model is expected to facilitate early identification of high-risk patients and enable timely intervention.
术后便秘常伴有腹痛、食欲不振、恶心呕吐，甚至发生不良心脑血管事件。本研究旨在建立预测老年髋部骨折患者术后新发便秘风险的列线图，并验证其性能。纳入2021年1月至2023年12月在我院接受髋部手术的患者。进行单因素和多因素逻辑回归分析，以确定影响术后便秘的显著因素。构建用于预测术后新发便秘的列线图，并检验其判别能力、一致性和临床实用性。共纳入1092例老年患者，其中955例无术前便秘患者用于建立列线图。多因素逻辑回归分析确定了10个与术后新发便秘相关的因素，包括体重指数、脑血管疾病、心血管疾病、胃肠道疾病、失血量、肾脏疾病、术前下肢血栓形成、心脏手术史、患者自控镇痛和术前肺部感染。构建了包含这些因素的列线图，训练集和测试集的受试者操作特征曲线下面积分别为0.730（0.692 - 0.768）和0.712（0.651 - 0.772）。本研究开发的列线图在预测老年髋部骨折手术患者术后新发便秘风险方面具有良好的判别能力。所提出的模型有望有助于早期识别高危患者并及时进行干预。
