摘要
目的:探讨影响老年患者肠镜检查前肠道准备质量的影响因素,构建肠道准备失败风险预测模型,并予以验证。方法:选取2021年9月至2023年10月于我院接受肠镜检查的500例老年患者(建模组),以肠道准备成败为依据将患者分为肠道准备成功组和肠道准备失败组,以单因素及Logistic回归分析肠道准备失败的危险因素,构建风险评估模型。以2023年11月至2024年3月于我院接受肠镜检查的200例老年患者作为验证组,以受试者工作特征曲线(ROC)和Hosmer-Lemeshowχ^(2)检验评估风险模型的预测效果。结果:Logistic回归分析显示,年龄≥65岁、BMI>24 kg/m^(2)、合并糖尿病、结直肠手术史、无肠镜检查史、BSFS分型1~2型为老年患者肠道准备失败的独立危险因素,P<0.05。构建风险模型,评分≥8分为高风险人群。建模组Hosmer-Lemeshowχ^(2)=8.870,P=2.254;ROC曲线下面积(AUC)为0.720,灵敏度为51.85%,特异度为80.95%;验证组Hosmer-Lemeshowχ^(2)=4.190,P=0.839;ROC AUC为0.726,灵敏度为49.20%,特异性为83.65%,准确率为72.68%。结论:老年患者肠镜检查前肠道准备失败受多因素影响,如年龄≥65岁、BMI>24 kg/m^(2)、合并糖尿病、结直肠手术史、无肠镜检查史、BSFS分型1~2型等。风险预测模型预测效果良好,有助于临床护理干预,提高结肠镜检查前肠道准备质量。
Objective To investigate the factors influencing the quality of bowel preparation before colonoscopy in elderly patients,and to construct and validate a risk prediction model for bowel preparation failure.Methods A total of 500elderly patients(modeling group)who received colonoscopy in our hospital from September 2021to October 2023were selected and divided into successful bowel preparation group and failed bowel preparation group according to the success or failure of bowel preparation.The risk factors of failed bowel preparation were analyzed by univariate and logistic regression analysis,and a risk assessment model was established.A total of 200elderly patients who underwent colonoscopy in our hospital from November 2023to March 2024were selected as the validation group.The predictive effect of the risk model was evaluated by receiver operating characteristic curve(ROC)and Hosmer-Lemeshowχ^(2) test.Results Logistic regression analysis showed that age≥65years old,BMI>24kg/m^(2),combined diabetes,history of colorectal operation,no history of colonoscopy,and BSFS type 1-2were independent risk factors for bowel preparation failure in elderly patients(P<0.05).The risk model was constructed,and patients with scores≥8were classified as the high-risk group.Hosmer-Lemeshow test showed thatχ^(2)=8.870and P=2.254in the modeling group.The area under ROC curve(AUC),sensitivity and specificity were 0.720,51.85%and 80.95%in the modeling group,respectively.Hosmer-Lemeshow test showedχ^(2)=4.190and P=0.839in the verification group.The AUC,sensitivity,specificity and accuracy were 0.726,49.20%,83.65%and 72.68%in the verification group,respectively.Conclusion The failure of bowel preparation before colonoscopy in elderly patients is affected by multiple factors,such as age≥65years,BMI>24kg/m^(2),combined diabetes,history of colorectal operation,no history of colonoscopy,and BSFS type 1-2.The prediction effect of risk prediction model is good,which is helpful for clinical nursing intervention and improving the quality of bowel preparation before colonoscopy.
作者
王静娴
索莉娜
禹菲菲
WANG Jing-xian;SUO Li-na;YU Fei-fei(International Medical Center,Henan Provincial People's Hospital,Zhengzhou,Henan 450000)
出处
《中国肛肠病杂志》
2024年第11期51-54,共4页
Chinese Journal of Coloproctology
关键词
结肠镜检查
肠道准备
影响因素
预测模型
Colonoscopy
Bowel preparation
Influencing factors
Prediction model
