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Journal of Nursing ›› 2022, Vol. 29 ›› Issue (11): 5-10.doi: 10.16460/j.issn1008-9969.2022.11.005

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Establishment of Nomogram Model to Predict Major Low Anterior Resection Syndrome in Patients with Rectal Cancer One Year after Sphincter-preserving Surgery

PANG Xue-ying1a, HU Shao-hua1b, LI Hui2, YIN Dan-qiao2, ZHANG Shang-xin1a, YANG Xiao-dong1a   

  1. 1a. Dept. of Gastrointestinal Surgery; 1b. Dept. of Nursing Administration, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China;
    2. School of Nursing ,Anhui Medical University, Hefei 230032, China
  • Received:2021-12-15 Online:2022-06-10 Published:2022-07-07

Abstract: Objective To investigate the risk factors of major low anterior resection syndrome (LARS) in patients with rectal cancer one year after sphincter-preserving surgery, and to construct a predictive model. Methods The patients who underwent sphincter-preserving surgery for rectal cancer in a tertiary grade-A hospital in Anhui Province were recruited retrospectively, and they were surveyed with the general information questionnaire and Low Anterior Resection Syndrome Score. The binary logistic regression model was used to analyze the risk factors, and R language to draw the nomogram to construct a risk predictive model. Results A total of 319 patients were enrolled in this study, of which 57 (17.9%) patients with rectal cancer still had major LARS one year after sphincter-preserving surgery. Logistic regression analysis showed that the distance from the tumor to the anal margin, prophylactic stoma, anastomotic leakage, preoperative radiotherapy and postoperative radiotherapy were independent risk factors for major LARS in patients with rectal cancer one year after sphincter-preserving surgery. The nomogram prediction model was constructed based on the logistic regression analysis. The C-index was 0.849 (95%CI:0.790~0.907); the area under the ROC curve (AUC) 0.843 (95%CI:0.784~0.901), which showed that the model had good discrimination. The Brier score and calibration curve showed good calibration, and H-L test(χ2=9.313,P=0.231)showed the model had good fitting. Conclusion The predictive model constructed in this study has a good prediction effect, which can intuitively identify high-risk patients with major LARS one year after sphincter-preserving surgery, and provide reference for early screening and intervention.

Key words: rectal cancer, sphincter-preserving surgery, low anterior resection syndrome, risk factor, risk predictive model, nomogram

CLC Number: 

  • R473.6
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