Scholarlink

Objective <p>The purpose of this research is to investigate risk factors for postoperative intestinal fistula combined with pulmonary infection in patients with acute intestinal obstruction and the construction of a predictive model.</p> Methods <p>Two hundred twenty-seven patients with acute intestinal obstruction admitted to our hospital from January 2018 to December 2024 were selected. Patients were divided into two groups based on whether postoperative intestinal fistula complicated with pulmonary infection occurred: the intestinal fistula complicated with pulmonary infection group (78 cases) and the control group (149 cases). Clinical data of patients were collected and peripheral blood levels of NLR and SAA were measured. Logistic regression analysis was employed to investigate the risk factors for postoperative intestinal fistula complicated with pulmonary infection in patients with acute intestinal obstruction. A nomogram model was established to predict the occurrence of postoperative intestinal fistula complicated with pulmonary infection in patients with acute intestinal obstruction. The goodness of fit of the predictive model was evaluated using the Hosmer-Lemeshow (H-L) chi-square test. The predictive value of the model was analyzed using receiver operating characteristic (ROC) curves and calibration curves.</p> Results <p>There were no statistical differences in age, gender ratio, intraoperative blood loss, operation duration, comorbidities, and smoking history between the two groups (all <i>P</i>&gt;0.05); The postoperative hospitalization duration, BMI index, NLR and SAA levels in the intestinal fistula with pulmonary infection group were significantly higher than those in the control group (all <i>P</i> &lt; 0.05). Logistic multivariate analysis indicated that BMI, NLR and SAA levels were independent factors for postoperative complications of intestinal fistula with pulmonary infection after acute intestinal obstruction surgery (all <i>P</i> &lt; 0.05). The nomogram prediction model constructed based on the three factors showed acceptable calibration and moderate-to-high discriminative ability with AUC of 0.912, sensitivity and specificity of 0.890 and 0.897, respectively. After internal validation, the value of AUC was 0.853, with sensitivity and specificity being 0.872 and 0.864, respectively.</p> Conclusion <p>BMI, NLR, and SAA are independent risk factors for postoperative intestinal fistula complicated with pulmonary infection in patients with acute intestinal obstruction. The predictive model constructed showed potentially useful predictive performance in this cohort for postoperative intestinal fistula complicated with pulmonary infection in such patients.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Risk factors and predictive nomogram for postoperative intestinal fistula complicated by pulmonary infection in patients with acute intestinal obstruction

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月1日

查看全文
  • Jun Gao,
  • Hao Sun,
  • Xiyan Qin,
  • Lei Na

摘要

Objective

The purpose of this research is to investigate risk factors for postoperative intestinal fistula combined with pulmonary infection in patients with acute intestinal obstruction and the construction of a predictive model.

Methods

Two hundred twenty-seven patients with acute intestinal obstruction admitted to our hospital from January 2018 to December 2024 were selected. Patients were divided into two groups based on whether postoperative intestinal fistula complicated with pulmonary infection occurred: the intestinal fistula complicated with pulmonary infection group (78 cases) and the control group (149 cases). Clinical data of patients were collected and peripheral blood levels of NLR and SAA were measured. Logistic regression analysis was employed to investigate the risk factors for postoperative intestinal fistula complicated with pulmonary infection in patients with acute intestinal obstruction. A nomogram model was established to predict the occurrence of postoperative intestinal fistula complicated with pulmonary infection in patients with acute intestinal obstruction. The goodness of fit of the predictive model was evaluated using the Hosmer-Lemeshow (H-L) chi-square test. The predictive value of the model was analyzed using receiver operating characteristic (ROC) curves and calibration curves.

Results

There were no statistical differences in age, gender ratio, intraoperative blood loss, operation duration, comorbidities, and smoking history between the two groups (all P>0.05); The postoperative hospitalization duration, BMI index, NLR and SAA levels in the intestinal fistula with pulmonary infection group were significantly higher than those in the control group (all P < 0.05). Logistic multivariate analysis indicated that BMI, NLR and SAA levels were independent factors for postoperative complications of intestinal fistula with pulmonary infection after acute intestinal obstruction surgery (all P < 0.05). The nomogram prediction model constructed based on the three factors showed acceptable calibration and moderate-to-high discriminative ability with AUC of 0.912, sensitivity and specificity of 0.890 and 0.897, respectively. After internal validation, the value of AUC was 0.853, with sensitivity and specificity being 0.872 and 0.864, respectively.

Conclusion

BMI, NLR, and SAA are independent risk factors for postoperative intestinal fistula complicated with pulmonary infection in patients with acute intestinal obstruction. The predictive model constructed showed potentially useful predictive performance in this cohort for postoperative intestinal fistula complicated with pulmonary infection in such patients.