Analysis of the risk factors of strangulated intestinal obstruction and establishment of a prediction model

Objective To investigate the risk factors of strangulated intestinal obstruction and construct a prediction model.Methods A total of 200 patients with small bowel obstruction who were admitted to Huai′an Hospital Affiliated to Xuzhou Medical University from 2018 to 2022 were enrolled and their clinical data were retrospectively analyzed. The following observation indexes were analyzed, including body temperature, heart rate, white blood cells, neutrophils, lymphocytes, monocytes, red blood cell distribution width, platelets, CRP, and procalcitonin. The univariate and multivariate Logistic regression analyses were performed to analyze the independent risk factors for strangulating ileus and plot a nomogram.Results Among the 200 patients with small bowel obstruction, 83 patients successfully underwent conservative treatment and were included in the conservative treatment group, while the remaining 84 patients who failed in conservative treatment underwent surgical treatment and were included in the surgical treatment group. There were statistical differences between the two groups as to peritoneal irritation, history of abdominal surgery, chronic disease, body temperature, neutrophils, CRP, procalcitonin, albumin, prealbumin, cholinesterase, D-dimer, NLR and PLR(P<0.05). The multivariate logistic regression analysis showed that albumin(OR=0.9,95%CI:0.83-0.98) was an independent protective factor against strangulated intestinal obstruction(P<0.05), while peritoneal irritation(OR=18.63,95%CI:2.16-161.06), history of abdominal surgery(OR=2.88,95%CI:1.25-6.63), and CRP(OR=1.02,95%CI:1.01-1.03) were the independent risk factors for strangulated intestinal obstruction(P<0.05).Conclusions The presence of peritoneal irritationsign, history of abdominal surgery, CRP and albumin are closely related to strangulated intestinal obstruction, with certain predictive value.