Comprehensively evaluate the short outcome of small bowel obstruction:A novel medical-economic score system
作者机构：Shengli Clinical Medical CollegeFujian Medical UniversityFuzhou 350122Fujian ProvinceChina Department of General Surgery(Emergency Surgery)Fujian Medical University Union HospitalFuzhou 350001Fujian ProvinceChina
出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)
年 卷 期：2023年第29卷第9期
页 面：1509-1522页
核心收录：
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
基 金：Supported by Joint Funds for the innovation of science and Technology,Fujian Province,No.2018Y9054 Young and Middle-Aged Talents Backbone Program of Fujian Province,No.2020GGA034 The Construction Project of Fujian Province Minimally Invasive Medical Center,No.76
主 题：Principal component analysis Small bowel obstruction Outcome evaluation system Risk factors Intensive clinical care Radiomics
摘 要：BACKGROUND Small bowel obstruction(SBO)still imposes a substantial burden on the health care *** evaluation systems for SBO outcomes only focus on a single *** comprehensive evaluation of outcomes for patients with SBO remains poorly *** intensive clinical care would effectively improve the short-term outcomes for SBO,however,the full spectrum of the potential risk status regarding the high complication-cost burden is *** We aim to construct a novel system for the evaluation of SBO outcomes and the identification of potential risk *** Patients who were diagnosed with SBO were enrolled and stratified into the simple SBO(SiBO)group and the strangulated SBO(StBO)group.A principal component(PC)analysis was applied for data simplification and the extraction of patient characteristics,followed by separation of the high PC score group and the low PC score *** identified independent risk status on admission via a binary logistic regression and then constructed predictive models for worsened management *** operating characteristic curves were drawn,and the areas under the curve(AUCs)were calculated to assess the effectiveness of the predictive *** Of the 281 patients,45 patients(16.0%)were found to have StBO,whereas 236 patients(84.0%)had *** standardized length of stay(LOS),total hospital cost and the presence of severe adverse events(SAEs),a novel principal component was extracted(PC score=0.429×LOS+0.444×total hospital cost+0.291×SAE).In the multivariate analysis,risk statuses related to poor results for SiBO patients,including a low lymphocyte to monocyte ratio(OR=0.656),radiological features of a lack of small bowel feces signs(OR=0.316)and mural thickening(OR=1.338),were identified as risk *** the StBO group,higher BUN levels(OR=1.478)and lower lymphocytes levels(OR=0.071)were *** AUCs of the predictive models for poor outcomes were 0.715(95%CI:0.635-0.795
维普期刊数据库