Risk factors and risk prediction model for mucocutaneous separation in enterostomy patients:A single center experience  

作　　者：Yun Liu Hong Li Jin-Jing Wu Jian-Hong Ye 

机构地区：[1]Department of Reconstructive,Hand and Plastic Surgery,Zhejiang Chinese Medical University,Lishui Central Hospital,289 Kuocang Road,Liandu District,Lishui 323000,Zhejiang Province,China [2]Department of Operation Room,Zhejiang Chinese Medical University,Lishui Central Hospital,289 Kuocang Road,Liandu District,Lishui 323000,Zhejiang Province,China

出　　处：《World Journal of Clinical Cases》2024年第33期6620-6628,共9页世界临床病例杂志（英文）

基　　金：Supported by the Zhejiang Province Medical and Health Science and Technology Plan Project,No.2022KY1427.

摘　　要：BACKGROUND Mucocutaneous separation(MCS)is a common postoperative complication in enterostomy patients,potentially leading to significant morbidity.Early identification of risk factors is crucial for preventing this condition.However,predictive models for MCS remain underdeveloped.AIM To construct a risk prediction model for MCS in enterostomy patients and assess its clinical predictive accuracy.METHODS A total of 492 patients who underwent enterostomy from January 2019 to March 2023 were included in the study.Patients were divided into two groups,the MCS group(n=110),and the non-MCS(n=382)based on the occurrence of MCS within the first 3 weeks after surgery.Univariate and multivariate analyses were used to identify the independent predictive factors of MCS and the model constructed.Receiver operating characteristic curve analysis was used to assess the model’s performance.RESULTS The postoperative MCS incidence rate was 22.4%.Suture dislodgement(P<0.0001),serum albumin level(P<0.0001),body mass index(BMI)(P=0.0006),hemoglobin level(P=0.0409),intestinal rapture(P=0.0043),incision infection(P<0.0001),neoadjuvant therapy(P=0.0432),stoma site(P=0.0028)and elevated intra-abdominal pressure(P=0.0395)were potential predictive factors of MCS.Suture dislodgement[P<0.0001,OR:28.007595%CI:(11.0901-82.1751)],serum albumin level(P=0.0008,OR:0.3504,95%CI:[0.1902-0.6485]),BMI[P=0.0045,OR:2.1361,95%CI:(1.2660-3.6235)],hemoglobin level[P=0.0269,OR:0.5164,95%CI:(0.2881-0.9324)],intestinal rapture[P=0.0351,OR:3.0694,95%CI:(1.0482-8.5558)],incision infection[P=0.0179,OR:0.2885,95%CI:(0.0950-0.7624)]and neoadjuvant therapy[P=0.0112,OR:1.9769,95%CI:(1.1718-3.3690)]were independent predictive factors and included in the model.The model had an area under the curve of 0.827 and good clinical utility on decision curve analysis.CONCLUSION The mucocutaneous separation prediction model constructed in this study has good predictive performance and can provide a reference for early warning of mucocutaneous separation in enterostomy patients

关 键 词：ENTEROSTOMY Mucocutaneous separation Risk assessment model Performance validation 

分 类 号：R656.9[医药卫生—外科学]