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Development and validation of a nomogram to predict the risk of constipation after lumbar interbody fusion surgery

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To understand the incidence of postoperative constipation and the risk factors of constipation in patients with lumbar interbody fusion, we constructed and verified the constipation risk prediction model, so as to provide reference for the prevention and treatment of postoperative constipation.

Methods

The data of patients undergoing lumbar interbody fusion in our hospital were retrospectively analyzed from December 2021 to December 2022. According to postoperative constipation, the patients were divided into constipation group and non-constipation group. Univariate logistic regression analysis and multivariate logistic regression analysis were used to determine independent risk factors for postoperative constipation. Based on independent risk factors, a nomogram was developed to predict the risk of constipation after lumbar interbody fusion. The prediction performance was assessed using receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA). Finally, bootstrapping method for internal validation was further evaluated the nomogram.

Results

A total of 282 patients participated in the study. 176 patients (62.41%) after lumbar interbody occurred constipation, and 106 patients were asymptomatic. Multivariate regression analysis showed independent risk factors, including the use of calcium channel blockers, polypharmacy, postoperative bed time, and constipation history. Multivariate regression analysis was used to establish the model. The C-index of the nomogram was 0.827 (95% CI 0.779–0.875), and the C-index of interval bootstrapping validation was 0.813 (95% CI 0.765–0.861), and the area under the AUC was 0.800. The nomogram showed good discrimination ability.

Conclusions

The use of calcium channel blockers, polypharmacy, postoperative bed time, and history of constipation are independent risk factors for postoperative constipation in patients undergoing lumbar interbody fusion. The constructed risk prediction model has good discriminative ability.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Funding

Supported by the Chongqing Medical Scientific Research Project (Grant No. 2024WSJK057).

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Author notes

  1. Qingshuai Yu and Zhengjian Yan contributed to this work equally and should be regarded as co-corresponding author.

Authors and Affiliations

  1. Department of Orthopedics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

    Mingxin Chen, Si Cheng, Dian Zhong, Tao Hu, Xin Wang, Zhongliang Deng, Qingshuai Yu & Zhengjian Yan

Authors
  1. Mingxin Chen
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  2. Si Cheng
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  3. Dian Zhong
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  4. Tao Hu
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  5. Xin Wang
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  6. Zhongliang Deng
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  7. Qingshuai Yu
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Correspondence to Qingshuai Yu or Zhengjian Yan.

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The authors declare no competing interests.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki and the study was approved by the Medical Ethics Committee of the Second affiliated hospital of Chongqing Medical University.

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Written informed consent was obtained from the parents.

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Chen, M., Cheng, S., Zhong, D. et al. Development and validation of a nomogram to predict the risk of constipation after lumbar interbody fusion surgery. Arch Orthop Trauma Surg 144, 1907–1916 (2024). https://doi.org/10.1007/s00402-024-05256-y

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  • DOI: https://doi.org/10.1007/s00402-024-05256-y

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