Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation
Abstract Objective To investigate the clinical characteristics of neonatal necrotizing enterocolitis (NEC) complicated by intestinal perforation and predict the incidence of intestinal perforation in NEC. Methods Neonates diagnosed with NEC at the Affiliated Hospital of Zunyi Medical University from...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Pediatrics |
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| Online Access: | https://doi.org/10.1186/s12887-024-04640-2 |
| _version_ | 1797273208609570816 |
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| author | Pei Huang Nandu Luo Xiaoqi Shi Jiahong Yan Jiaojiao Huang Yan Chen Zuochen Du |
| author_facet | Pei Huang Nandu Luo Xiaoqi Shi Jiahong Yan Jiaojiao Huang Yan Chen Zuochen Du |
| author_sort | Pei Huang |
| collection | DOAJ |
| description | Abstract Objective To investigate the clinical characteristics of neonatal necrotizing enterocolitis (NEC) complicated by intestinal perforation and predict the incidence of intestinal perforation in NEC. Methods Neonates diagnosed with NEC at the Affiliated Hospital of Zunyi Medical University from January 2012 to May 2022 were enrolled, and the clinical data were collected and analyzed retrospectively. The patients were divided into two groups based on intestinal perforation occurrence or not. Mann-Whitney U tests, t-tests, chi-square tests, and fisher’s exact tests were performed between-group comparisons. Logistic and lasso regressions were applied to screen independent risk factors for concomitant bowel perforation, and R software (RMS package) was used to formulate the nomogram prediction model. In addition, the receiver operating curve (ROC) and the calibration curve were drawn to verify the predictive power, while decision curve analysis (DCA) was constructed to evaluate the clinical applicability of the nomogram model. Results One hundred eighty neonates with NEC were included, of which 48 had intestinal perforations, and 132 did not; the overall incidence of intestinal perforation was 26.67% (48/180). Bloody stool (OR = 5.60), APTT ≥ 50 s (OR = 3.22), thrombocytopenia (OR = 4.74), and hypoalbuminemia (OR = 5.56) were identified as independent risk variables for NEC intestinal perforation (P < 0.05) through multivariate logistic regression analysis. These factors were then applied to develop a nomogram prediction model (C-index = 0.838) by using the R software. The area under the curve (AUC) for the nomogram in the training and validation cohorts were 0.838 (95% Cl: 0.768, 0.908) and 0.802 (95% CI: 0.659, 0.944), respectively. The calibration curve shown that the nomogram has a good predictive ability for predicting the risk of intestinal perforation occurrence. And the decision curve and clinical impact curve analyses demonstrated good clinical utility of the nomogram model. Conclusion We found that Bloody stool, APTT ≥ 50 s, Thrombocytopenia, and hypoalbuminemia could be used as independent risk factors for predicting intestinal perforation in neonates with NEC. The nomogram model based on these variables had high predictive values to identify NEC patients with intestinal perforation. |
| first_indexed | 2024-03-07T14:41:17Z |
| format | Article |
| id | doaj.art-ee45c9c2f0024c36ada325d63a05ad15 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-03-07T14:41:17Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-ee45c9c2f0024c36ada325d63a05ad152024-03-05T20:22:53ZengBMCBMC Pediatrics1471-24312024-02-0124111210.1186/s12887-024-04640-2Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforationPei Huang0Nandu Luo1Xiaoqi Shi2Jiahong Yan3Jiaojiao Huang4Yan Chen5Zuochen Du6Department of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityDepartment of Pediatrics, Affiliated Hospital of Zunyi Medical UniversityAbstract Objective To investigate the clinical characteristics of neonatal necrotizing enterocolitis (NEC) complicated by intestinal perforation and predict the incidence of intestinal perforation in NEC. Methods Neonates diagnosed with NEC at the Affiliated Hospital of Zunyi Medical University from January 2012 to May 2022 were enrolled, and the clinical data were collected and analyzed retrospectively. The patients were divided into two groups based on intestinal perforation occurrence or not. Mann-Whitney U tests, t-tests, chi-square tests, and fisher’s exact tests were performed between-group comparisons. Logistic and lasso regressions were applied to screen independent risk factors for concomitant bowel perforation, and R software (RMS package) was used to formulate the nomogram prediction model. In addition, the receiver operating curve (ROC) and the calibration curve were drawn to verify the predictive power, while decision curve analysis (DCA) was constructed to evaluate the clinical applicability of the nomogram model. Results One hundred eighty neonates with NEC were included, of which 48 had intestinal perforations, and 132 did not; the overall incidence of intestinal perforation was 26.67% (48/180). Bloody stool (OR = 5.60), APTT ≥ 50 s (OR = 3.22), thrombocytopenia (OR = 4.74), and hypoalbuminemia (OR = 5.56) were identified as independent risk variables for NEC intestinal perforation (P < 0.05) through multivariate logistic regression analysis. These factors were then applied to develop a nomogram prediction model (C-index = 0.838) by using the R software. The area under the curve (AUC) for the nomogram in the training and validation cohorts were 0.838 (95% Cl: 0.768, 0.908) and 0.802 (95% CI: 0.659, 0.944), respectively. The calibration curve shown that the nomogram has a good predictive ability for predicting the risk of intestinal perforation occurrence. And the decision curve and clinical impact curve analyses demonstrated good clinical utility of the nomogram model. Conclusion We found that Bloody stool, APTT ≥ 50 s, Thrombocytopenia, and hypoalbuminemia could be used as independent risk factors for predicting intestinal perforation in neonates with NEC. The nomogram model based on these variables had high predictive values to identify NEC patients with intestinal perforation.https://doi.org/10.1186/s12887-024-04640-2NeonateNecrotizing enterocolitisNomogramIntestinal perforationRisk factor |
| spellingShingle | Pei Huang Nandu Luo Xiaoqi Shi Jiahong Yan Jiaojiao Huang Yan Chen Zuochen Du Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation BMC Pediatrics Neonate Necrotizing enterocolitis Nomogram Intestinal perforation Risk factor |
| title | Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation |
| title_full | Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation |
| title_fullStr | Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation |
| title_full_unstemmed | Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation |
| title_short | Risk factor analysis and nomogram prediction model construction for NEC complicated by intestinal perforation |
| title_sort | risk factor analysis and nomogram prediction model construction for nec complicated by intestinal perforation |
| topic | Neonate Necrotizing enterocolitis Nomogram Intestinal perforation Risk factor |
| url | https://doi.org/10.1186/s12887-024-04640-2 |
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