Constructing a prediction model of inflammatory bowel disease recurrence based on factors affecting the quality of life

Maojuan Li; Yan Tao; Yang Sun; Jing Wu; Fengrui Zhang; Yunling Wen; Min Gong; Jingxian Yan; Hao Liang; Xinyu Bai; Junkun Niu; Yinglei Miao

doi:10.3389/fmed.2023.1041505

Constructing a prediction model of inflammatory bowel disease recurrence based on factors affecting the quality of life

Front Med (Lausanne). 2023 Mar 9:10:1041505. doi: 10.3389/fmed.2023.1041505. eCollection 2023.

Authors

Maojuan Li^{1

2}, Yan Tao^{1

2}, Yang Sun^{1

2}, Jing Wu^{1

2}, Fengrui Zhang^{1

2}, Yunling Wen^{1

2}, Min Gong^{1

2}, Jingxian Yan^{1

2}, Hao Liang^{1

2}, Xinyu Bai^{1

2}, Junkun Niu^{1

2}, Yinglei Miao^{1

2}

Affiliations

¹ Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
² Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China.

Abstract

Aim: This study aimed to determine the factors affecting the quality of life of patients with inflammatory bowel disease (IBD) and to construct a disease recurrence prediction model based on these influencing factors.

Methods: A prospective, single-center study in China was conducted between October 2020 and March 2021. The quality of life of patients was assessed using the Inflammatory Bowel Disease Questionnaire (IBDQ). Multiple stepwise regression analysis was used to analyze the factors influencing the quality of life of patients with IBD. The chi-square test and the point-biserial correlation analysis were performed to identify factors associated with clinical recurrence. A binary logistic regression model was constructed to predict the recurrence. The receiver operating characteristic curve was used to evaluate the prediction model. Patients with IBD from April 2021 to June 2021 were randomly included for model verification to evaluate the disease recurrence prediction model.

Results: The average IBDQ score of patients with IBD was 172.2 ± 35.0 (decreased by 23.2%). The scores of all dimensions of the IBDQ were decreased, especially emotional function and systemic symptoms. Disease activity, age, extraintestinal manifestations (EIMs), and annual household income were important factors influencing the IBDQ scores of patients with ulcerative colitis, and these accounted for ~57.0% of the factors affecting the quality of life. Disease activity, EIMs, and occupational stress were important factors influencing the IBDQ scores of patients with Crohn's disease, and they accounted for approximately 75.1% of the factors affecting the quality of life. Annual household income, occupational stress, and IBDQ scores were independent risk factors for recurrence. The area under the curve of the recurrence prediction model was 81.1%. The sensitivity and specificity were 81.7 and 71.7%, respectively. The Youden index of the model was 0.534. The established recurrence prediction model has good discriminant validity in the validation cohort.

Conclusion: The quality of life of patients with IBD was generally poor. The use of factors affecting the quality of life to predict disease recurrence has high predictive value and can support the management of IBD by selecting patients at a higher risk for relapse.

Keywords: inflammatory bowel disease; influencing factors; prediction model; quality of life; recurrence.

Grants and funding

This study was supported by the Natural Science Foundation of China (U1802282, 81960108, 82170550, and 82160107); Yunnan Health Training Project of High Level Talents (H-2019050); Yunnan Ten Thousand Talents Plan Young and Elite Talents Project; Applied Basic Research Projects of Yunnan Province (202201AY070001-086).