Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2024; 12(33): 6620-6628
Published online Nov 26, 2024. doi: 10.12998/wjcc.v12.i33.6620
Risk factors and risk prediction model for mucocutaneous separation in enterostomy patients: A single center experience
Yun Liu, Hong Li, Jin-Jing Wu, Jian-Hong Ye
Yun Liu, Hong Li, Jin-Jing Wu, Department of Reconstructive, Hand and Plastic Surgery, Zhejiang Chinese Medical University, Lishui Central Hospital, 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China
Jian-Hong Ye, Department of Operation Room, Zhejiang Chinese Medical University, Lishui Central Hospital, 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China
Author contributions: Liu Y and Ye JH contributed to conceptualization; Liu Y contributed to methodology; Li H contributed to writing—original draft preparation; Wu JJ and Ye JH contributed to writing—review and editing; contributed to supervision; All authors have read and agreed to the published version of the manuscript.
Supported by the Zhejiang Province Medical and Health Science and Technology Plan Project, No. 2022KY1427.
Institutional review board statement: This study was approved by the Ethics Committee of Zhejiang University of Traditional Chinese Medicine Teaching Hospital, Lishui Central Hospital. The study was conducted in line with the Helsinki Declaration.
Informed consent statement: All study participants, or their legal guardians, provided written consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Underlying data is restricted by patient privacy restrictions. Data requests may be made to the corresponding author.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Hong Ye, MSc, Department of Operation Room, Zhejiang Chinese Medical University, Lishui Central Hospital, 289 Kuocang Road, Liandu District, Lishui 323000, Zhejiang Province, China. 442339139@qq.com
Received: May 20, 2024
Revised: September 5, 2024
Accepted: September 11, 2024
Published online: November 26, 2024
Processing time: 130 Days and 4.9 Hours
Abstract
BACKGROUND

Mucocutaneous separation (MCS) is a common postoperative complication in enterostomy patients, potentially leading to significant morbidity. Early identification of risk factors is crucial for preventing this condition. However, predictive models for MCS remain underdeveloped.

AIM

To construct a risk prediction model for MCS in enterostomy patients and assess its clinical predictive accuracy.

METHODS

A total of 492 patients who underwent enterostomy from January 2019 to March 2023 were included in the study. Patients were divided into two groups, the MCS group (n = 110), and the non-MCS (n = 382) based on the occurrence of MCS within the first 3 weeks after surgery. Univariate and multivariate analyses were used to identify the independent predictive factors of MCS and the model constructed. Receiver operating characteristic curve analysis was used to assess the model’s performance.

RESULTS

The postoperative MCS incidence rate was 22.4%. Suture dislodgement (P < 0.0001), serum albumin level (P < 0.0001), body mass index (BMI) (P = 0.0006), hemoglobin level (P = 0.0409), intestinal rapture (P = 0.0043), incision infection (P < 0.0001), neoadjuvant therapy (P = 0.0432), stoma site (P = 0.0028) and elevated intra-abdominal pressure (P = 0.0395) were potential predictive factors of MCS. Suture dislodgement [P < 0.0001, OR: 28.0075 95%CI: (11.0901-82.1751)], serum albumin level (P = 0.0008, OR: 0.3504, 95%CI: [0.1902-0.6485]), BMI [P = 0.0045, OR: 2.1361, 95%CI: (1.2660-3.6235)], hemoglobin level [P = 0.0269, OR: 0.5164, 95%CI: (0.2881-0.9324)], intestinal rapture [P = 0.0351, OR: 3.0694, 95%CI: (1.0482-8.5558)], incision infection [P = 0.0179, OR: 0.2885, 95%CI: (0.0950-0.7624)] and neoadjuvant therapy [P = 0.0112, OR: 1.9769, 95%CI: (1.1718-3.3690)] were independent predictive factors and included in the model. The model had an area under the curve of 0.827 and good clinical utility on decision curve analysis.

CONCLUSION

The mucocutaneous separation prediction model constructed in this study has good predictive performance and can provide a reference for early warning of mucocutaneous separation in enterostomy patients.

Keywords: Enterostomy; Mucocutaneous separation; Risk assessment model; Performance validation

Core Tip: In this study a risk prediction model for mucocutaneous separation in enterostomy patients was developed, identifying key predictive factors such as suture dislodgement, serum albumin levels, and body mass index. The model demonstrated strong predictive accuracy with an area under the curve of 0.827, offering a valuable tool for early intervention and improved patient outcomes in clinical practice.