Prognostic model of postoperative adhesive intestinal obsruction risk in children

Abstract

Objective: to develop a prognostic model of the postoperative adhesive intestinal obstruction risk in children by the use of multivariate statistics. Materials and methods: To create a model for the prediction of the postoperative adhesive intestinal obstruction by using the method of binary logistic regression, a retrospective analysis of the features of the acute inflammatory disease of the abdominal cavity organs and treatment strategy in 119 children. Results: The level of significance of clinical and anamnestic signs in children with appendicular peritonitis and the postoperative adhesive intestinal obstruction was determined using Pearson’s test χ2. The main factors (leukopenia at hospitalization) (p=0.033) pronounced stigmatization with signs of connective tissue dysplasia (p=0.013) and duration of surgery (p=0.0002) were highlighted, which indicate the postoperative adhesive intestinal obstruction risk. The logistic regression method was used to create a prognostic model for calculating the postoperative adhesive intestinal obstruction risk, which was assessed as “very good” by ROC analysis (test sensitivity – 77%; specificity – 72%): AUC = 0.796. Conclusions: The application of the proposed prognostic model of the postoperative adhesive intestinal obstruction risk in children with acute inflammatory diseases of the abdominal organs allows to make decision as for the extent of surgery and optimization of treatment strategy at all stages of rendering care.