To explore the risk factors of intestinal obstruction in elderly patients with acute incarcerated inguinal hernia and the establishment of a risk alignment chart model to provide a reference for clinical nursing work.

A retrospective analysis of clinical data of 259 elderly patients aged 60 years or older who were treated in Beijing Tongren hospital for acute incarcerated inguinal hernia from June 2012 to June 2018. According to whether complicated with intestinal obstruction, the patients were divided into intestinal obstruction group and non-intestinal obstruction group. Univariate and Logistic regression multivariate analysis were used to analyze the independent risk factors for intestinal obstruction in elderly patients with acute incarcerated inguinal hernia. Then, the selected independent risk factors were incorporated to establish a nomogram prediction model, and the predictability and accuracy of the model were verified.

Logistic regression analysis of clinical data of two groups of patients showed that age (OR=3.515, 95% CI: 1.437-8.601), diabetes (OR=4.506, 95% CI: 1.519-13.372), and malignant tumors (OR=8.805, 95% CI: 2.349-33.011), history of abdominal surgery (OR=17.526, 95% CI: 3.986-77.067), incarceration time (OR=3.937, 95% CI: 1.615-9.598), and postoperative infection (OR=2.770, 95% CI: 1.147-6.686) were independent risk factors for intestinal obstruction in elderly patients with acute incarcerated inguinal hernia, with a statistically significant difference (P<0.05). Based on six independent risk factors (age, diabetes, malignant tumors, history of abdominal surgery, incarceration time, and postoperative infection) for intestinal obstruction in elderly patients with acute incarcerated inguinal hernia, a nomogram model for the prediction of intestinal obstruction in elderly patients with acute incarcerated inguinal hernia was established. After verification, the predicted value was basically same as the measured value, which indicated that the nomogram model of this study had a good prediction ability. At the same time, this study uses Bootstrap internal verification method for the collinear model. The graph model is verified. The C-index is as high as 0.846 (95% CI: 0.812-0.880). The ROC of the model for the diagnosis of elderly acute incarcerated inguinal hernia complicated by intestinal obstruction was also as high as 0.846, indicating that the nomogram model of this study had good accuracy and discrimination.

Elderly patients with acute incarcerated inguinal hernia have a higher risk of intestinal obstruction. Age, diabetes, malignancy, history of abdominal surgery, incarceration time, and postoperative infection are independent risk factors for intestinal obstruction in elderly patients with acute incarcerated inguinal hernia. The establishment of predictive models of risk factors and related nomograms can improve the diagnostic efficacy of intestinal obstruction in elderly patients with acute incarcerated inguinal hernia, and provide a direction for further optimization of the nursing model. It has high clinical application value and is worth further promotion.