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- Title
Analysis of Risk Factors of Pelvic Organ Prolapse in Postmenopausal Women and Construction of Prediction Model.
- Authors
Xiaohong Xie; Jiejie Shen
- Abstract
Background • The incidence of Pelvic organ prolapse (POP) was as high as 50% in women, with the main symptoms of vaginal tissue prolapse, accompanied by urination, defecation, and sexual dysfunction, which affected patients’ quality of life. POP is more prominent in postmenopausal women due to various factors. By constructing a model, we predict POP and expect to reduce the incidence of POP. Objective • To explore the risk factors for POP in postmenopausal women and develop a predictive model that can identify high-risk individuals early so that targeted preventive measures can be taken to reduce the burden of POP. Methods • Using retrospective studies, 290 menopausal women treated in the Department of Gynecology of the Ninth People’s Hospital of Suzhou from January 2019 to December 2022 were selected as the study subjects. Women with menopause were divided into the POP group (62 cases) and a non-POP group (228 cases) according to whether or not POP occurred. Single factor analysis was performed on the two data groups. The risk factors of POP in menopausal women were screened by multivariate logistic regression analysis. Based on the screening results, a graph prediction model expressed as a nomogram is constructed. The model’s effectiveness was analyzed by the goodness of fit test and receiver operating characteristic curve (ROC) curve. The decision curve was used to analyze the clinical effectiveness of the model. Results • Multifactor logistic regression analysis showed that Older age (OR = 2.309, P = .007), more childbirth frequency (OR = 3.121, P = .002), low expression of estradiol (E2) (OR = 1.499, P = .023), low expression of serum 25-hydroxyvitamin D3[25-(OH)D3] (OR = 2.073, P = .011), and lower blood calcium (OR = 21.677, P = .014) were all risk factors for POP in menopausal women. Based on the above indicators, a risk prediction model is constructed. The model has been proved to have good recognition ability, areas under curve (AUC) = 0.887 (95%CI: 0.845-0.926), The best cutoff value is 0.37, The sensitivity and specificity were 0.885 and 0.840, respectively; The goodness of fit test showed that the predicted value of the model had no statistical significance with the actual value. The threshold probability is in the range of 1%~99%. The net benefit of menopausal women is higher than the other two extreme curves. It shows that the model is clinically effective. Conclusion • Age, times of delivery, E2, 25-(OH)D3, and blood calcium are related to POP in menopausal women. A nomogram model based on these 5 indicators can effectively assess the risk of POP in postmenopausal women. The clinician can use this column chart to calculate the risk of POP occurrence for each patient and make clinical recommendations accordingly.
- Subjects
PELVIC organ prolapse; VAGINAL diseases; POSTMENOPAUSE; QUALITY of life; SEXUAL dysfunction
- Publication
Alternative Therapies in Health & Medicine, 2024, Vol 30, Issue 1, p265
- ISSN
1078-6791
- Publication type
Article