Risk prediction model for adhesive intestinal obstruction after laparoscopic appendectomy
Photo by Dan Meyers / Unsplash
Key Takeaway
Consider that prolonged disease duration, SIRS, elevated WBC/NLR, and low albumin may be associated with adhesive intestinal obstruction after laparoscopic appendectomy.
This retrospective cohort study included 298 patients with acute appendicitis who underwent laparoscopic surgery. The study aimed to develop a risk prediction model for adhesive intestinal obstruction (AIO) by comparing patients who developed AIO (AIO group) with those who did not (non-AIO group).
Results showed that disease duration was significantly longer in the AIO group compared with the non-AIO group (p < 0.05). The prevalence of systemic inflammatory response syndrome (SIRS) was higher in the AIO group, and white blood cell count (WBC) and neutrophil-to-lymphocyte ratio (NLR) were elevated. Albumin (ALB) levels were lower in the AIO group. All differences were statistically significant (p < 0.05).
No specific effect sizes or absolute numbers were reported for these outcomes. Follow-up was conducted via telephone, but the duration was not specified. Safety and tolerability data were not reported.
Limitations include the retrospective design, lack of reported effect sizes, and absence of multivariable adjustment details. The study does not establish causality. Clinicians should interpret these findings cautiously until validated in prospective cohorts.
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View Original Abstract ↓
BackgroundAdhesive intestinal obstruction (AIO) is a recognized complication following laparoscopic surgery for acute appendicitis (AA), although its overall incidence remains relatively low. This study aimed to develop a risk prediction model based on clinical characteristics and laboratory indicators to facilitate early identification and prevention of postoperative AIO.MethodsIn this retrospective cohort study, 298 AA patients who underwent laparoscopic surgery between January 2020 and November 2024 were enrolled. Patients were categorized into AIO (n = 32) and non-AIO (n = 266) groups. Data were collected from electronic medical records and telephone follow-ups. Univariate analysis compared clinical and laboratory variables between groups. Significant variables underwent collinearity analysis, and those without collinearity were entered into binary logistic regression to identify independent predictors. A nomogram prediction model was constructed and internally validated using bootstrap resampling. Model performance was assessed using calibration curves and the area under the receiver operating characteristic curve (AUC).ResultsCompared with the non-AIO group, the AIO group exhibited significantly longer disease duration, a higher prevalence of systemic inflammatory response syndrome (SIRS), elevated white blood cell count (WBC), increased neutrophil-to-lymphocyte ratio (NLR), and lower albumin (ALB) levels (p 1, p
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