This study aimed to determine the factors that contribute to the failure of bowel preparation in patients undergoing colonoscopy and to develop a risk prediction model. A total of 1115 outpatients were included. Patients were randomly divided into two groups: the modeling group (669 patients) and the validation group (446 patients). In the modeling group, patients were further divided into two groups based on their success and failure in bowel preparation using the Boston Bowel Preparation Scale. A logistic regression analysis model was used to determine the risk factors of bowel preparation failure, which was subsequently visualized using an alignment diagram. After controlling for relevant confounders, multifactorial logistic regression results showed that age ≥ 60 years (OR = 2.246), male (OR = 2.449), body mass index ≥ 24 (OR = 2.311), smoking (OR = 2.467), chronic constipation (OR = 5.199), diabetes mellitus (OR = 5.396) and history of colorectal surgery (OR = 5.170) were influencing factors of bowel preparation failure. The area under the ROC curve was 0.732 in the modeling group and 0.713 in the validation group. According to the calibration plot, the predictive effect of the model and the actual results were in good agreement. Age ≥ 60 years, male, body mass index ≥ 24, smoking, chronic constipation, diabetes mellitus, and history of colorectal surgery are independent risk factors for bowel preparation failure. The established prediction model has a good predictive efficacy and can be used as a simple and effective tool for screening patients at high risk for bowel preparation failure.

中文翻译：

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结肠镜检查前肠道准备失败风险预测模型的建立

本研究旨在确定导致接受结肠镜检查的患者肠道准备失败的因素并开发风险预测模型。共纳入门诊患者1115人。患者被随机分为两组：模型组（669 名患者）和验证组（446 名患者）。在模型组中，根据患者使用波士顿肠道准备量表进行肠道准备的成功和失败情况，将患者进一步分为两组。使用逻辑回归分析模型来确定肠道准备失败的危险因素，随后使用对齐图将其可视化。控制相关混杂因素后，多因素Logistic回归结果显示，年龄≥60岁（OR=2.246）、男性（OR=2.449）、体重指数≥24（OR=2.311）、吸烟（OR=2.467）、慢性便秘（ OR = 5.199）、糖尿病（OR = 5.396）和结直肠手术史（OR = 5.170）是肠道准备失败的影响因素。模型组的ROC曲线下面积为0.732，验证组的ROC曲线下面积为0.713。根据校准图，模型的预测效果与实际结果吻合较好。年龄≥60岁、男性、体重指数≥24、吸烟、慢性便秘、糖尿病、结直肠手术史是肠道准备失败的独立危险因素。建立的预测模型具有良好的预测效果，可作为筛查肠道准备失败高危患者的简单有效的工具。