关键词: 食管裂孔疝, 胃底折叠术, 日间手术, 预测模型

Abstract: Objective To analyze the independent factors of discharge within 24 hours after operation of hiatal hernia and to construct a scoring model to predict discharge within 24 hours.
Methods The clinical data of 32 patients with hiatal hernia in Xijing Hospital from October 2017 to October 2019 were retrospectively analyzed,and the independent risk factors affecting discharge 24 hours after operation were analyzed.According to the weight of risk factors,a scoring model was constructed to predict discharge 24 hours after hiatal hernia operation.
Results In all 32 patients with hiatal hernia,13(40.8%) were discharged within 24 hours after operation.The surgeon with experience on day surgery and the time of operation were independent risk factors of discharge within 24 hours after operation.The prediction model was constructed based on these two factors.When the model score exceeded 1.408,the case was discharged within 24 hours after operation.The positive prediction rate was 1.000(95%CI:0.735-1.000),whereas the negative prediction rate was 0.950(95%CI：0.751-0.999).Predicted model AUC 0.992(95%CI:0.973-1.000),sensitivity0.923(95%CI:0.640-0.998),specificity1.000(95%CI:0.823-1.000),accuracy0.969(95%CI:0.838-0.999).The clinical decision curve shows that the use of this prediction model has significant clinical benefits under any risk probability.
Conclusion A scoring model based on surgeon with experience on day surgery and operation time can accurately predict the possibility of discharge within 24 hours after operation.

Key words: hiatal hernia, fundoplication, day surgery, prediction model