Adults With Acute Ischemic Intestinal Necrosis Multivariate Logistic Regression Analysis

Objective To investigate the main risk factors of the acute ischemic intestinal necrosis, to establish the Logistic regression model and to evaluate the accuracy,sensitivity and specificity for predicting the intestinal necrosis in adult patients.Methods We chosed244patients who were diagnosed as acute ischemic intestinal necrosis during surgical operation in the Affiliated Hospital of Qingdao University Medical College in the past4.5years as study group. In whole,220patients at the same period involved in the study were the cases admitted with adhesived intestinal obstruction,who are the control group. Case-control study was used to retrospectively investigate the clinical data of acute ischemic intestinal necrosis cases and adhesived intestinal obstruction cases. Firstly, single factor analysis was used. Secondly, multiplevariate Logistic regression analysis was used in the selected variables. Then, Logistic regression equation was estiblished, which can be used to evaluate the accuracy, sensitivity and specificity of intestinal necrosis in adult.Results13clinical variables, including abdominal pain continue aggravation, peritonitis, bowel sounds diminished or disappeared, preoperative count of leukocyte, pH value, Lactate, creatine kinase levels, preoperative urea nitrogen, history of abdominal operation, intestinal wall thickening, mesenteric edema, pneumatosis and target sign were selected through single factor analysis. By Logistic regression analysis, it was revealed that there were eigth significant factors for the intestinal necrosis in adult in diminishing sequence as abdominal pain continue aggravation, preoperative count of leukocyte, preoperative urea nitrogen,creatine kinase levels, bowel sounds diminished or disappeared, intestinal mesenteric edema, intestinal wall thickening, pH value. Logistic regression equation:P=1/(1+e (1.364+1.816X1+0.282X2+0.281X3+0.007X4-0.576X5-1.534X6-1.959X7-1.889X8))) The accuracy, specificity and sensitivity of the Logistic model were85.56%,90.16%and73.18%.Conclusion Abdominal pain continue aggravation, preoperative count of leukocyte,preoperative urea nitrogen,creatine kinase levels,bowel sounds diminished or disappeared, intestinal mesenteric edema, intestinal wall thickening, pH value were the main risk factors to decide the happening of the acute ischemic intestinal necrosis in adult, and they can direct the surgical intervention and guidance. The Logistic regressive model based on these factors is reliable in predicting the happening of the acute ischemic intestinal necrosis in adult.