Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis

Abstract Purpose This study aims to explore the value of multiple indicators in the evaluation of risk factors for intestinal adhesion (IA) after appendectomy in children with acute appendicitis (AA). Methods A retrospective study was conducted on 608 patients who underwent appendectomy in the Depar...

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Main Authors: Dezhao Liu, Yuchi Wang, Liyun Sun, Lijia Pan, Junkui Wang, Ying Lu, Zhao Cui, Jingying Li, Hui Geng
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Pediatrics
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Online Access:https://doi.org/10.1186/s12887-024-05213-z
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author Dezhao Liu
Yuchi Wang
Liyun Sun
Lijia Pan
Junkui Wang
Ying Lu
Zhao Cui
Jingying Li
Hui Geng
author_facet Dezhao Liu
Yuchi Wang
Liyun Sun
Lijia Pan
Junkui Wang
Ying Lu
Zhao Cui
Jingying Li
Hui Geng
author_sort Dezhao Liu
collection DOAJ
description Abstract Purpose This study aims to explore the value of multiple indicators in the evaluation of risk factors for intestinal adhesion (IA) after appendectomy in children with acute appendicitis (AA). Methods A retrospective study was conducted on 608 patients who underwent appendectomy in the Department of Pediatric Surgery, Children’s Medical Center of Jilin Province from January 2017 to April 2023, with a one-year follow-up period to record the occurrence of IA after appendectomy. Univariate and multivariate analysis were used to screen the risk factors of postoperative IA, and a prediction model was established to predict postoperative IA. Results There were 527 patients in the non-IA group and 81 patients in the IA group. Binary Logistic regression was used to determine the strength of correlation with postoperative intestinal adhesion. The risk factors identified were as follows: DS ≥ 43 h (OR = 3.903, 5points), CRP ≥ 65 mg/L (OR = 3.424, 4.5points), PCT ≥ 0.9 µg/L (OR = 8.683, 8points), Surgical duration ≥ 100 min (OR = 6.457, 7points), Appendiceal perforation (OR = 6.073, 6.5points), Postoperative exhaust time ≥ 55 h (OR = 14.483, 10points). After test, the nomogram drawn based on binary logistic regression can obtain good prediction efficiency. In the training set, the area under the curve was 0.960, the sensitivity was 0.898, and the specificity was 0.905. In the test set, the area under the curve was 0.957, the sensitivity was 0.864, and the specificity was 0.906. Conclusion Postoperative exhaust time ≥ 55 h has a high risk of IA after appendicitis surgery in children. Early recovery of intestinal peristalsis function is essential. This scoring model is a novel and promising method for predicting postoperative IA.
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spelling doaj-art-8c88439dbd9843d6b0870b683e0ef49c2024-11-17T12:49:03ZengBMCBMC Pediatrics1471-24312024-11-0124111110.1186/s12887-024-05213-zEstablishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitisDezhao Liu0Yuchi Wang1Liyun Sun2Lijia Pan3Junkui Wang4Ying Lu5Zhao Cui6Jingying Li7Hui Geng8Graduate School, Changchun University of Chinese MedicineDepartment of Pediatric Surgery, Children’s Medical Center of Jilin ProvinceGraduate School, Changchun University of Chinese MedicineGraduate School, Changchun University of Chinese MedicineGraduate School, Changchun University of Chinese MedicineDepartment of Pediatric Surgery, Children’s Medical Center of Jilin ProvinceDepartment of Pediatric Surgery, Children’s Medical Center of Jilin ProvinceDepartment of Pediatric Surgery, Children’s Medical Center of Jilin ProvinceGraduate School, Changchun University of Chinese MedicineAbstract Purpose This study aims to explore the value of multiple indicators in the evaluation of risk factors for intestinal adhesion (IA) after appendectomy in children with acute appendicitis (AA). Methods A retrospective study was conducted on 608 patients who underwent appendectomy in the Department of Pediatric Surgery, Children’s Medical Center of Jilin Province from January 2017 to April 2023, with a one-year follow-up period to record the occurrence of IA after appendectomy. Univariate and multivariate analysis were used to screen the risk factors of postoperative IA, and a prediction model was established to predict postoperative IA. Results There were 527 patients in the non-IA group and 81 patients in the IA group. Binary Logistic regression was used to determine the strength of correlation with postoperative intestinal adhesion. The risk factors identified were as follows: DS ≥ 43 h (OR = 3.903, 5points), CRP ≥ 65 mg/L (OR = 3.424, 4.5points), PCT ≥ 0.9 µg/L (OR = 8.683, 8points), Surgical duration ≥ 100 min (OR = 6.457, 7points), Appendiceal perforation (OR = 6.073, 6.5points), Postoperative exhaust time ≥ 55 h (OR = 14.483, 10points). After test, the nomogram drawn based on binary logistic regression can obtain good prediction efficiency. In the training set, the area under the curve was 0.960, the sensitivity was 0.898, and the specificity was 0.905. In the test set, the area under the curve was 0.957, the sensitivity was 0.864, and the specificity was 0.906. Conclusion Postoperative exhaust time ≥ 55 h has a high risk of IA after appendicitis surgery in children. Early recovery of intestinal peristalsis function is essential. This scoring model is a novel and promising method for predicting postoperative IA.https://doi.org/10.1186/s12887-024-05213-zAcute appendicitisIntestinal adhesionAppendectomyChildren
spellingShingle Dezhao Liu
Yuchi Wang
Liyun Sun
Lijia Pan
Junkui Wang
Ying Lu
Zhao Cui
Jingying Li
Hui Geng
Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
BMC Pediatrics
Acute appendicitis
Intestinal adhesion
Appendectomy
Children
title Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
title_full Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
title_fullStr Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
title_full_unstemmed Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
title_short Establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
title_sort establishment and validation of a nomogram for predicting postoperative intestinal adhesion in children with acute appendicitis
topic Acute appendicitis
Intestinal adhesion
Appendectomy
Children
url https://doi.org/10.1186/s12887-024-05213-z
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