老年人结肠镜检查肠道准备失败风险预测模型的建立与验证

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基金项目 四川省干部保健科研课题，编号：川干研2021⁃234；昆明医科大学第二附属医院院内护理专项科研项目，编号：2021hyk004

Abstract  Objective：To establish the risk predictive model for inadequate bowel preparation before colonoscopy in the elderly，and to verify the model internally and externally，and to test its prediction effect.Methods：507 patients undergoing colonoscopy in a tertiary grade A hospital in Kunming city from February to August 2021 were prospectively collected as model group.According to whether intestinal preparation failure occurred，they were divided into successful group（376 cases） and failed group（131 cases）.Logistic regression prediction model was established and transformed into a risk scoring system.The area under the ROC curve and Hosmer⁃Lemeshow test were used to test the differentiation and calibration of the model respectively，and 10⁃fold cross validation was used to verify the model internally.A total of 238 patients from September to November 2021 were selected for external validation of the model.Results：Logistic regression analysis showed that age≥75 years，diabetes，exercise habits，BSFS typing，frail and walking function status were the independent influencing factors of inadequate bowel preparation in the elderly.The area under the ROC curve of the model group was 0.806，and the Hosmer⁃Lemeshow test result showed that the P⁃value was 0.870.The optimal truncation value was 3 points，and the sensitivity，specificity and Youden index of the model were 61.83%，85.11% and 0.469 respectively.The mean area under ROC curve verified by 10⁃fold cross⁃validation was 0.785±0.090.The area under ROC curve of the validation group was 0.824，the Hosmer⁃Lemeshow test result showed that that the P⁃value was 0.907，the sensitivity was 73.13%，the specificity was 80.70%，and the Youden index was 0.538.Conclusions：The constructed the risk predictive model for inadequate bowel preparation before colonoscopy in the elderly can better predict the occurrence of inadequate bowel preparation in the elderly.It can provide an assessment tool for health care workers to screen older adults at high risk for intestinal preparation failure.

Keywords  elderly； colonoscopy； inadequate bowel preparation； prediction model； risk score

摘要  目的：建立老年人结肠镜检查肠道准备失败风险预测模型，并对模型进行验证，检验其预测效果。（剩余13467字）