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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 5/2023

07-04-2023 | Original Article

A multi-analysis of nomogram model for the identification of banded adhesions and matted adhesions in adhesive small bowel obstruction

Authors: Yong Wei, Tianran Liao, Xinchang Shangguan, Manduo Ouyang, Zhiyong Chen, Enshuang Zheng, Bingqiang Lin, Xianqiang Chen

Published in: European Journal of Trauma and Emergency Surgery | Issue 5/2023

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Abstract

Background

Preoperative diagnosis of the cause of adhesive small bowel obstruction (ASBO) is very challenging for surgeons. We aimed to develop a nomogram model for the identification of banded adhesions (BA) and matted adhesions (MA) of ASBO.

Methods

This retrospective study enrolled patients with ASBO between January 2012 and December 2020, classified into BA and MA groups according to the intraoperative findings. A nomogram model was developed by using multivariable logistic regression analysis.

Results

A total of 199 patients were included, with 117 (58.8%) cases of BA and 82 (41.2%) cases of MA. There were 150 patients designed for training the model, and the other 49 cases for validation. Multivariate logistic regression analysis showed that prior surgery for once (p = 0.008), white blood cells (WBC) (p = 0.001), beak sign (p < 0.001), fat notch sign (p = 0.013), and mesenteric haziness (p = 0.005) were independently associated with BA. The AREA under the receiver operating characteristic curve (AUC-ROC) of the nomogram model in the training and validation sets were 0.861 (95% CI 0.802–0.921) and 0.884 (95% CI 0.789–0.980), respectively. The calibration plot demonstrated a good agreement. A decision curve analysis demonstrated that the nomogram model was clinically useful.

Conclusions

The multi-analysis of the nomogram model might have a favorable clinical applicability for the identification of BA and MA in patients with adhesive small bowel obstruction.
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Metadata
Title
A multi-analysis of nomogram model for the identification of banded adhesions and matted adhesions in adhesive small bowel obstruction
Authors
Yong Wei
Tianran Liao
Xinchang Shangguan
Manduo Ouyang
Zhiyong Chen
Enshuang Zheng
Bingqiang Lin
Xianqiang Chen
Publication date
07-04-2023
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 5/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-023-02270-4

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