输尿管镜碎石术后病人延迟出院预测模型构建与验证  

Construction and verification of delayed discharge prediction model for patients after ureteroscopic lithotripsy

作　　者：唐玲 袁钰 TANG Ling;YUAN Yu(Nanchang People's Hospital,Jiangxi 330009 China)

机构地区：[1]南昌市人民医院,330009

出　　处：《全科护理》2025年第4期622-627,共6页Chinese General Practice Nursing

基　　金：江西省卫生计生委科技计划项目,编号:20177044。

摘　　要：目的:分析输尿管镜碎石术后病人延迟出院的影响因素,并进行预测模型的构建与验证。方法:回顾性选取2021年1月—2024年1月在医院行输尿管镜碎石术的病人240例,根据术后是否延迟出院分为延迟组与无延迟组,通过单因素和进一步Logistic回归分析筛选病人输尿管镜碎石术后延迟出院的独立影响因素,并进行预测模型的构建与验证。结果:Logistic回归分析结果表明,年龄、糖尿病、手术时间、术后导尿管留置时间、术后发热、术后疼痛均为输尿管镜碎石术后病人延迟出院的独立影响因素(均P<0.05),根据此结果构建了风险预测列线图模型。建模集ROC曲线下面积为0.948[95%CI(0.914,0.981)],约登指数为0.802,敏感度、特异度分别为0.914,0.888,校准曲线中MAE为0.014,H-L拟合优度检验结果显示χ^(2)=4.808,P=0.778;验证集ROC曲线下面积为0.973[95%CI(0.945,1.000)],约登指数为0.886,敏感度、特异度分别为1.000,0.886,校准曲线中平均绝对误差(MAE)为0.023,表明模型的一致性较好。结论:高龄、患有糖尿病、手术时间和导尿管留置时间长、术后发热及疼痛均为输尿管镜碎石术后病人延迟出院的危险因素,以此构建的风险预测列线图模型具有较高的临床应用价值。Objective:To analyze the influencing factors of delayed discharge of patients after ureteroscopic lithotripsy,and to construct and verify the prediction model.Methods:A total of 240 patients who underwent ureteroscopic lithotripsis in hospital from January 2021to January 2024 were retrospectively selected and divided into delayed group and no delayed group according to whether they were discharged late after surgery.The independent influencing factors of delayed discharge after ureteroscopic lithotripsy were screened by single factor and further Logistic regression analysis,and the prediction model was constructed and verified.Results:Logistic regression analysis showed that age,diabetes mellitus,operation time,catheter retention time,postoperative fever and postoperative pain were all independent influencing factors for delayed discharge of patients after ureteroscopic lithotripsy(all P<0.05).Based on this result,a risk prediction Nomogram model was constructed.The area under ROC curve of the modeling set was 0.948[95%CI(0.914,0.981)],the Yoden index was 0.802,the sensitivity and specificity were 0.914 and 0.888 respectively,the MAE in the calibration curve was 0.014,and the H-L goodness of fit test results showed χ^(2)=4.808,P=0.778.The area under the ROC curve of the verification set was 0.973[95%CI(0.945,1.000)],the Yoden index was 0.886,the sensitivity and specificity were 1.000 and 0.886,respectively,and the MAE in the calibration curve was 0.023,indicating a good consistency of the model.Conclusion:Advanced age,diabetes mellitus,operation time and catheter retention time,and postoperative fever and pain are risk factors for delayed discharge after ureteroscopic lithotripsy.The predictive Nomogram model established by this method has high clinical application value.

关 键 词：输尿管结石 输尿管镜碎石术 延迟出院 预测模型 

分 类 号：R473.6[医药卫生—护理学]