Multiplevariate Logistic Analysis Of The Necessity Of Operative Treatment And Establishment Of Risk Model For Intestinal Obstruction

Objective To investigate the main risk factors of the Necessity of Operative Treatment, to establish the Logistic regression model and to evaluate the accuracy, sensitivity and specificity for predicting the Necessity of Operative Treatment for intestinal Obstruction.Methods All the 596 patients involved in the study were the cases admitted with intestinal Obstruction in the Affiliated Hospital of Qingdao University Medical College in the past 3.5 years. Case-control study was used to retrospectively investigate the clinical data of intestinal Obstruction cases.Firstly,exclude the cases which must be operated by CT.secondly,single factor analysis was used. Then, multiplevariate Logistic regression analysis was used in the selected variables.Results 14 clinical variables,including high fever,length of period of expectant treatment, nausea and vomiting,abdominal pain continue aggravation, abdominal mass with tenderness,peritonitis, preoperative count of leukocyte,preoperative hemoglobin, preoperative urea nitrogen, preoperative creatinine, preoperative total bilirubin,history of abdominal operation and air-fluid level were selected through single factor analysis. By Logistic regression analysis,it was revealed that there were seven significant factors for the Necessity of Operative Treatment in diminishing sequence as abdominal mass with tenderness, peritonitis,high fever,abdominal pain continue aggravation,length of period of expectant treatment,preoperative count of leukocyte,history of abdominal operation. Logistic regression equation:P The accuracy, specificity and sensitivity of the Logistic model were 75.79%, 68.40%and83.09%.Conclusion Abdominal mass with tenderness,peritonitis,high fever,abdominal pain continue aggravation,length of period of expectant treatment,preoperative count of leukocyte,history of abdominal operation were the main risk factors of the Necessity of Operative Treatment in intestinal Obstruction. The Logistic regressive model based on these factors is reliable in predicting the Necessity of Operative Treatment.