Risk factor analysis of gallbladder stones with occult common bile duct stones and construction and validation of a column chart risk prediction model
LIU Yong-qing,WANG Cheng-hong,MENG Tao
Department of Hepatobiliary and Pancreatic Surgery, Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui230000,China
Abstract:
Objective To explore the risk factors of gallbladder stones with occult common bile duct stones and establish a column chart model. Methods 343 patients with gallstones who underwent surgical treatment in our hospital from January 2016 to February 2024 were selected. According to whether the patient has occult common bile duct stones, they are divided into simple gallbladder stones group (n=299),and occult common bile duct stones group (n=44). Screening the risk factors for gallbladder stones with occult common bile duct stones through univariate and binary logistic regression analysis, and establishing a column chart model. Verify the model's discrimination, accuracy, and clinical applicability through receiver operating characteristic curve (ROC), calibration curve, decision curve analysis (DCA), and clinical impact curve. Results The proportion of patients with choledochal diameter, alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), gallbladder stone site involving the neck, and multiple gallbladder stones was higher in the combined occult choledochal stone group than in the simple choledochal stone group (P <0.05).An increase in the diameter of the common bile duct (OR=1.421, 95%CI: 1.221-1.653), an increase in ALP (OR=1.012, 95%CI: 1.002-1.022), an increase in GGT (OR=1.080, 95%CI: 1.058-1.102), and multiple gallstones (OR=3.042, 95%CI: 1.267-7.304) were independent risk factors for gallbladder stones with occult common bile duct stones (P <0.05). The ROC curve analysis showed that the column chart model predicted an AUC of 0.964 (95%CI: 0.872-0.983) for occult common bile duct stones. The calibration curve analysis showed that the predicted probability of the model was highly consistent with the actual probability. The analyses of DCA and clinical impact curve showed that at each threshold probability value, the clinical net benefit was greater than 0, and the column chart model's prediction of occult common bile duct stones was basically consistent with the actual situation. Conclusion The diameter of the common bile duct, the number of gallstones, ALP, and GGT are closely related to occult common bile duct stones in patients with gallbladder stones. A column chart model constructed based on these factors can provide a reference for identifying high-risk patients and has certain clinical applicability.
