Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction
Abstract Background Preoperatively diagnosing irreversible intestinal ischemia in patients with strangulated bowel obstruction is difficult. Therefore, this study aimed to establish a prediction model for irreversible intestinal ischemia in strangulated bowel obstruction. Methods We included 83 pati...
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| Format: | Article |
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BMC
2022-08-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-022-01769-8 |
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| author | Toshimichi Kobayashi Naokazu Chiba Itsuki Koganezawa Masashi Nakagawa Kei Yokozuka Shigeto Ochiai Takahiro Gunji Toru Sano Koichi Tomita Satoshi Tabuchi Eiji Hidaka Shigeyuki Kawachi |
| author_facet | Toshimichi Kobayashi Naokazu Chiba Itsuki Koganezawa Masashi Nakagawa Kei Yokozuka Shigeto Ochiai Takahiro Gunji Toru Sano Koichi Tomita Satoshi Tabuchi Eiji Hidaka Shigeyuki Kawachi |
| author_sort | Toshimichi Kobayashi |
| collection | DOAJ |
| description | Abstract Background Preoperatively diagnosing irreversible intestinal ischemia in patients with strangulated bowel obstruction is difficult. Therefore, this study aimed to establish a prediction model for irreversible intestinal ischemia in strangulated bowel obstruction. Methods We included 83 patients who underwent emergency surgery for strangulated bowel obstruction between January 2014 and March 2022. The predictors of irreversible intestinal ischemia in strangulated bowel obstruction were identified using logistic regression analysis, and a prediction model for irreversible intestinal ischemia in strangulated bowel obstruction was established using the regression coefficients. Receiver operating characteristic analysis and fivefold cross-validation was used to assess the model. Results The prediction model (range, 0–4) was established using a white blood cell count of ≥ 12,000/µL and the computed tomography value of peritoneal fluid that was ≥ 20 Hounsfield units. The areas of the receiver operating characteristic curve of the new prediction model were 0.814 and 0.807 after fivefold cross-validation. A score of ≥ 2 was strongly suggestive of irreversible intestinal ischemia in strangulated bowel obstruction and necessitated bowel resection (odds ratio = 15.938). The bowel resection rates for the prediction scores of 0, 2, and 4 were 15.2%, 66.7%, and 85.0%, respectively. Conclusion Our model may help predict irreversible intestinal ischemia that necessitates bowel resection for strangulated bowel obstruction cases and thus enable surgeons to recognize the severity of the situation, prepare for deterioration of patients with progression of intestinal ischemia, and select the appropriate surgical procedure for treatment. |
| first_indexed | 2024-04-13T01:42:23Z |
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| id | doaj.art-d5cfe7f0bdc241659a62c15be884a875 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-13T01:42:23Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-d5cfe7f0bdc241659a62c15be884a8752022-12-22T03:08:08ZengBMCBMC Surgery1471-24822022-08-012211710.1186/s12893-022-01769-8Prediction model for irreversible intestinal ischemia in strangulated bowel obstructionToshimichi Kobayashi0Naokazu Chiba1Itsuki Koganezawa2Masashi Nakagawa3Kei Yokozuka4Shigeto Ochiai5Takahiro Gunji6Toru Sano7Koichi Tomita8Satoshi Tabuchi9Eiji Hidaka10Shigeyuki Kawachi11Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterDepartment of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical CenterAbstract Background Preoperatively diagnosing irreversible intestinal ischemia in patients with strangulated bowel obstruction is difficult. Therefore, this study aimed to establish a prediction model for irreversible intestinal ischemia in strangulated bowel obstruction. Methods We included 83 patients who underwent emergency surgery for strangulated bowel obstruction between January 2014 and March 2022. The predictors of irreversible intestinal ischemia in strangulated bowel obstruction were identified using logistic regression analysis, and a prediction model for irreversible intestinal ischemia in strangulated bowel obstruction was established using the regression coefficients. Receiver operating characteristic analysis and fivefold cross-validation was used to assess the model. Results The prediction model (range, 0–4) was established using a white blood cell count of ≥ 12,000/µL and the computed tomography value of peritoneal fluid that was ≥ 20 Hounsfield units. The areas of the receiver operating characteristic curve of the new prediction model were 0.814 and 0.807 after fivefold cross-validation. A score of ≥ 2 was strongly suggestive of irreversible intestinal ischemia in strangulated bowel obstruction and necessitated bowel resection (odds ratio = 15.938). The bowel resection rates for the prediction scores of 0, 2, and 4 were 15.2%, 66.7%, and 85.0%, respectively. Conclusion Our model may help predict irreversible intestinal ischemia that necessitates bowel resection for strangulated bowel obstruction cases and thus enable surgeons to recognize the severity of the situation, prepare for deterioration of patients with progression of intestinal ischemia, and select the appropriate surgical procedure for treatment.https://doi.org/10.1186/s12893-022-01769-8Bowel strangulationIntestinal ischemiaPredictionComputed tomographySurgical emergencyPreoperative diagnosis |
| spellingShingle | Toshimichi Kobayashi Naokazu Chiba Itsuki Koganezawa Masashi Nakagawa Kei Yokozuka Shigeto Ochiai Takahiro Gunji Toru Sano Koichi Tomita Satoshi Tabuchi Eiji Hidaka Shigeyuki Kawachi Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction BMC Surgery Bowel strangulation Intestinal ischemia Prediction Computed tomography Surgical emergency Preoperative diagnosis |
| title | Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction |
| title_full | Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction |
| title_fullStr | Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction |
| title_full_unstemmed | Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction |
| title_short | Prediction model for irreversible intestinal ischemia in strangulated bowel obstruction |
| title_sort | prediction model for irreversible intestinal ischemia in strangulated bowel obstruction |
| topic | Bowel strangulation Intestinal ischemia Prediction Computed tomography Surgical emergency Preoperative diagnosis |
| url | https://doi.org/10.1186/s12893-022-01769-8 |
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