Khare Atul, Kothari Reena, Kateha Dinesh, Verma Amrendra, Agarwal Pawan, Sharma Dhananjaya
Department of Pediatric Surgery, SMS Medical College, Jaipur Rajasthan, India.
Department of General Surgery, NSCB Medical College, Garha Jabalpur, MP, India.
Turk J Surg. 2025 Sep 3;41(3):241-247. doi: 10.47717/turkjsurg.2025.2025-3-5. Epub 2025 Jul 11.
Postoperative ileus (POI) is a significant complication after ileostomy closure, which results in recurrent vomiting, dehydration, delay in starting enteral feeding, and even anastomotic breakdown. We aimed to develop a prediction model for POI occurrence after ileostomy closure.
One hundred consecutive patients undergoing ileostomy closure were studied prospectively and data of various demographic and clinical variables were recorded in a predesigned proforma. The final prediction model was developed using logistic regression and internally validated in the next 50 patients.
Factors associated with POI were age, body mass index, tobacco or alcohol addiction, comorbidity, anemia, thrombocytopenia, renal dysfunction, as shown by creatinine level, hypoproteinemia, hypernatremia, and hypokalemia. The mean score of those who developed POI was higher (p=0.002) than those who did not. A cut-off at score 8 had a sensitivity of 85.71%, specificity of 73.12%, and area under the curve was 0.8241 (SE 0.1123). The predictive model was validated in the next 50 consecutive patients and showed good sensitivity (80%) and specificity (93.3%).
Our predictive model can determine the occurrence of POI with accuracy.
术后肠梗阻（POI）是回肠造口关闭术后的一种重要并发症，可导致反复呕吐、脱水、肠内喂养延迟，甚至吻合口破裂。我们旨在建立一个预测回肠造口关闭术后POI发生的模型。
前瞻性研究了100例连续接受回肠造口关闭术的患者，并在预先设计的表格中记录了各种人口统计学和临床变量的数据。使用逻辑回归建立最终预测模型，并在接下来的50例患者中进行内部验证。
与POI相关的因素有年龄、体重指数、吸烟或酗酒、合并症、贫血、血小板减少、肾功能不全（以肌酐水平表示）、低蛋白血症、高钠血症和低钾血症。发生POI者的平均评分高于未发生者（p = 0.002）。评分8分时，敏感性为85.71%，特异性为73.12%，曲线下面积为0.8241（标准误0.1123）。该预测模型在接下来连续的50例患者中得到验证，显示出良好的敏感性（80%）和特异性（93.3%）。
我们的预测模型能够准确地确定POI的发生。
