[Development Review of Novel Laparoscope Technology]

Effect of nursing model based on risk prediction with Logistic regression model on recovery of gastrointestinal motility function and quality of life in patients after gynecological laparoscopy

BACKGROUND

Laparoscopic surgery is a common treatment in gynecology. Although it is a typical minimally invasive procedure, postoperative complications still exist and affect early postoperative recovery. Logistic regression models can be developed to obtain the weights of independent variables and to understand the risk factors for postoperative complications after laparoscopy, which can help to develop intervention strategies.

AIM

To evaluate the effect of a nursing model based on the risk prediction with a Logistic regression model on the early postoperative recovery, gastrointestinal motility, and quality of life in patients after gynecological laparoscopy.

METHODS

The case data of 232 patients undergoing gynecological laparoscopy at our hospital from January 2019 to January 2021 were selected to construct a Logistic regression model to predict the independent risk factors and incidence of gastrointestinal dysfunction after gynecological laparoscopy. Ninety-eight patients who would undergo gynecological laparoscopic surgery were prospectively selected and divided into either a control group or an observation group according to the order in which they were filed, with 49 cases in each group. The control group was given routine care, and the observation group adopted a care model based on the risk prediction using the Logistic regression model. The postoperative recovery status (time to first exhaust, time to first defecation, time to recovery of bowel sounds, and time to gastrointestinal peristalsis) and quality of life were compared between the two groups.

RESULTS

Among 232 patients undergoing gynecological laparoscopy, the incidence of postoperative gastrointestinal dysfunction was 38.36%. Logistic regression analysis showed that age ≥ 60 years old, time to postoperative start of activity ≥ 3 d, drainage tube indwelling time ≥ 7 d, abnormal postoperative potassium, no use of postoperative analgesia, and no use of postoperative gastrointestinal motility drugs were independent risk factors for gastrointestinal dysfunction after gynecological laparoscopic surgery (P < 0.05). Based on these independent risk factors, a Logistic regression model was constructed, and the receiver operating characteristic curve (ROC) was drawn based on the predicted value and the true value. When Logistic (P) was > 0.209, the area under the curve was 0.859, the predictive sensitivity was 95.92%, and the specificity was 93.27%. The time to first exhaustion, time to first defecation, time to bowel sound recovery, and time to gastrointestinal peristalsis were shorter in the observation group than in the control group (P < 0.05). After intervention, the quality of life of patients in the observation group was significantly better than that of the control group (P < 0.05).

CONCLUSION

The nursing model based on risk prediction using a Logistic regression model can promote the early recovery of patients undergoing gynecological laparoscopy, accelerate the recovery of gastrointestinal function, and improve their postoperative quality of life.