腹腔镜前列腺癌根治术患者出院准备度预警模型的构建

Construction of warning model for discharge readiness of patients undergoing laparoscopic radical prostatectomy

  • 摘要:
    目的 分析腹腔镜前列腺癌根治术(LRP)患者出院准备度的现状和影响因素, 构建预警模型。
    方法 采用便利抽样方法选取162例LRP患者作为研究对象,于患者出院当日采用一般资料和疾病相关资料调查表、出院准备度量表收集相关信息,分析LRP术后患者出院准备度的影响因素并构建预警模型。
    结果 45例患者出院当日未做好出院准备,占27.78%。二元Logistic回归分析结果显示,入院时排尿功能障碍(OR=0.091, 95%CI: 0.029~0.290)、术前PSA(OR=0.847, 95%CI: 0.728~0.986)、术前前列腺体积(OR=0.838, 95%CI: 0.782~0.898)和Barthel指数评分(OR=1.128, 95%CI: 1.086~1.173)均为LRP术后患者出院准备度的独立预测因素(P < 0.05)。LRP术后患者出院准备度的预警模型公式为Y=-24.0×X1-1.7×X2-1.8×X3+2.4×X4, 其中Y为出院准备度, X1为排尿功能障碍(否=0, 是=1), X2为术前PSA, X3为术前前列腺体积, X4为Barthel指数评分。受试者工作特征曲线显示,预警模型预测LRP术后患者出院准备度的曲线下面积为0.951(95%CI: 0.916~0.985), 约登指数为0.811, 最佳临界值为8分; Hosmer-Lemeshow拟合优度检验结果显示, χ2=4.864, P=0.772。
    结论 LRP术后患者出院准备度预警模型效能较好,可为临床实施早期、强化的出院健康指导及拟定相关决策提供参考依据。

     

    Abstract:
    Objective To analyze the status quo and influencing factors of discharge readiness of patients undergoing laparoscopic radical prostatectomy (LRP), and establish an warning model.
    Methods A total of 162 patients undergoing LRP were recruited as participants using convenience sampling. At discharge, general data and disease-related information questionnaires were used to collect related information, and the influencing factors of hospital discharge readiness of patients after LRP were analyzed and an early warning model was established.
    Results A total of 45 participants did not prepare well for hospital discharge, accounting for 27.78%. Binary Logistic regression analysis showed that urinary dysfunction on admission (OR=0.091; 95%CI, 0.029 to 0.290), preoperative PSA (OR=0.847; 95%CI, 0.728 to 0.986), preoperative prostate volume (OR=0.838; 95%CI, 0.782 to 0.898) and Barthel index score (OR=1.128; 95%CI, 1.086 to 1.173) were independent predictors of hospital readiness after LRP (P < 0.05). The warning model predicting discharge readiness for patients undergoing LRP was as follows: Y=-24.0×X1-1.7×X2-1.8×X3+2.4×X4 Y referring to discharge readiness; X1 referring to urination dysfunction (no=0, yes=1), X2 referring to preoperative PSA, X3 referring to preoperative prostate volume, X4 referring to Barthel score. The receiver operating characteristic curve showed that the area under the curve of warning model to predict the discharge readiness of patients after LRP was 0.951 (95%CI, 0.916 to 0.985), the Jorden index was 0.811, and the optimal critical value was 8 points. The Hosmer-Lemeshow goodness of fit test showed that the chi-square value was 4.864 and P value was 0.772.
    Conclusion The early warning model of discharge readiness of patients after LRP operation has a good efficacy, and can provide a reference for the implementation of early and intensive discharge health guidance and the formulation of relevant decisions.

     

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