Analysis of risk factors for poor prognosis after perianal abscess surgery
XU Yuchao1, SUN Yinggang2, TAN Jingzhong1, ZHANG Yali3, MI Wenning1
1. Department of Colorectal Surgery, 2. Department of Gastrointestinal Surgery, 3. Department of Anal Rehabilitation, the 960th Hospital of PLA Joint Logistics Support Force, Jinan 250031, China
Abstract：Objective To explore the influencing factors for poor prognosis in patients after perianal abscess surgery, and construct a quantitative risk evaluation model. Methods A total of 145 patients with perianal abscess who underwent surgical treatment in the 960th Hospital of PLA Joint Logistics Support Force from July 2022 to March 2024 were retrospectively selected and followed up for 6 months. The patients were divided into a good prognosis group (n=93) and a poor prognosis group (n=52). The clinical data of the two groups were compared, and the influencing factors for poor prognosis in patients after perianal abscess surgery was screened using multiple logistic regression analysis. Based on the results of multiple regression analysis, a Nomogram evaluation model was constructed using R software and rms package. Bootstrap method was used for internal validation, and calibration curves and receiver operating characteristic (ROC) curves were drawn to evaluate the predictive efficiency of the model. Results Multivariate Logistic analysis showed that body mass index (BMI) ≥ 28 kg/m2, diabetes, deep abscess, horseshoe abscess and simple incision and drainage surgery were risk factors for the poor prognosis (P<0.05). Based on the results of multifactor analysis, a Nomogram evaluation model was constructed to evaluate the risk of poor prognosis in patients with perianal abscess surgery. After verification, its internal consistency index (C-index) was 0.884 (95% CI: 0.836~0.931), the calibration curve showed that calibration curve had good consistency with the ideal curve, and the ROC curve showed that the sensitivity, specificity and area under the curve of the model for predicting poor prognosis were 88.46%, 89.25% and 0.905 (95% CI: 0.851~0.959) respectively. Conclusions BMI ≥ 28 kg/m2, diabetes, deep abscess, horseshoe abscess, and simple incision and drainage are all risk factors for poor prognosis in patients with perianal abscess, and the quantitative risk Nomogram evaluation model based on this analysis can effectively guide the early screening of high-risk patients with poor prognosis and timely formulate corresponding intervention strategies to improve prognosis.
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2025, Vol. 36 
