基于ROC模型预测老年急性胆囊炎患者发生术后感染风险的临床研究  

Clinical study on predicting postoperative infection risk in elderly patients with acute cholecystitis based on ROC model

作　　者：孙慧慧 马莉红[1] 陶敏 Sun Hui-hui;Ma Li-hong;Tao Min(Department of General Surgery,The First People's Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第一人民医院综合外科病区,河南郑州450000

出　　处：《四川生理科学杂志》2024年第12期2624-2627,2631,共5页

基　　金：河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20191024)。

摘　　要：目的:探讨基于受试者工作特征曲线(Receiver operating characteristic,ROC)诊断模型预测老年急性胆囊炎患者发生术后临床感染的风险因素。方法:将我院2023年01月20至2024年02月诊治的114例老年急性胆囊炎患者作为研究对象,按照患者发生术后感染的情况将患者分为感染组46例,未感染组68例。分析两组患者发生术后感染发生风险因素的单因素,采用多因素Logistic回归分析评估患者发生术后感染的风险因素。采用ROC曲线预测老年急性胆囊炎患者发生术后感染的临床风险因素。结果:感染组中≥70岁、糖尿病、肝硬化、胆囊周边积液、胆囊结石、白细胞计数>10×10^(9)·L^(-1)者占比均高于未感染组。经多因素Logistic回归分析,上述单因素风险因素为术后感染的风险因素(P<0.05)。ROC曲线分析显示,年龄≥70岁、糖尿病、肝硬化、胆囊周边积液、胆囊结石、白细胞计数>10×10^(9)·L^(-1)对患者发生术后感染风险有较高的预测价值(AUC>0.70)。结论:年龄≥70岁、糖尿病、胆囊周边积液、肝硬化、胆囊结石、白细胞计数>10×10^(9)·L^(-1)因素均可能导致老年急性胆囊炎患者发生术后感染的临床风险指标。Objective:Exploring the diagnostic model based on receiver operating characteristic curve(ROC)to predict the risk factors for postoperative clinical infection in elderly patients with acute cholecystitis.Method:114 elderly patients with acute cholecystitis treated in our hospital from January 2023 to February 2024 were selected as the study subjects.According to the incidence of postoperative infection,the patients were divided into an infection group of 46 cases and a non-infection group of 68 cases.The single factor risk factors for postoperative infection in two groups of patients were analyzed,and the risk factors for postoperative infection in patients were evaluated with multivariate logistic regression analysis.The clinical risk factors for postoperative infection in elderly patients with acute cholecystitis were predicted using ROC curves.Result:The proportions of age≥70 years,cirrhosis,diabetes,gallstone,fluid around gallbladder,white blood cell count>10×10^(9)·L^(-1)in the infected group were higher than those in the uninfected group(P<0.05).According to multiple logistic regression analysis,the above factors were identified as risk factors for postoperative infection(P<0.05).ROC curve analysis showed that age≥70 years,cirrhosis,diabetes,gallstone,fluid around gallbladder,white blood cell count>10×10^(9)·L^(-1)had a high predictive value for patients with postoperative infection risk(AUC>0.70).Conclusion:Age≥70 years old,diabetes,fluid around gallbladder,cirrhosis,white blood cell count>10×10^(9)·L^(-1)gallstone,and other factors may be clinical risk indicators of postoperative infection in elderly patients with acute cholecystitis.

关 键 词：ROC 老年急性胆囊炎 术后感染 风险 

分 类 号：R657.4[医药卫生—外科学]