Risk factors for not achieving stoma self‐care proficiency at hospital discharge and development of a clinical prediction model: A study based on the Danish Stoma Database

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Autori principali: Marianne Krogsgaard, Trine Bolette Borglit, Tobias Wirenfeldt Klausen, Eva Carlsson, Gerd Friis Bille, Bo Marcel Christensen, Ismail Gögenur
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Pubblicazione: Wiley 2026
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author Marianne Krogsgaard
Trine Bolette Borglit
Tobias Wirenfeldt Klausen
Eva Carlsson
Gerd Friis Bille
Bo Marcel Christensen
Ismail Gögenur
author_facet Marianne Krogsgaard
Trine Bolette Borglit
Tobias Wirenfeldt Klausen
Eva Carlsson
Gerd Friis Bille
Bo Marcel Christensen
Ismail Gögenur
Marianne Krogsgaard
Trine Bolette Borglit
Tobias Wirenfeldt Klausen
Eva Carlsson
Gerd Friis Bille
Bo Marcel Christensen
Ismail Gögenur
collection Wiley Open Access
contents Risk factors for not achieving stoma self‐care proficiency at hospital discharge and development of a clinical prediction model: A study based on the Danish Stoma Database Marianne Krogsgaard Trine Bolette Borglit Tobias Wirenfeldt Klausen Eva Carlsson Gerd Friis Bille Bo Marcel Christensen Ismail Gögenur Colorectal Disease Abstract Aim Stoma self‐care is critical for long‐term adaptation. Personalised approaches may help identify patients needing additional guidance during initial admission. This study aimed to examine factors associated with not achieving stoma self‐care proficiency and develop a risk model for use in clinical practice. Method We linked prospective health data from the Danish Stoma Database Capital Region and the Danish Anaesthesia Database. Multiple logistic regression analysis provided risk factors associated with not achieving stoma self‐care proficiency. The C‐statistic was used to evaluate the discriminative ability of logistic regression models. Data were randomly split into training and validation sets to develop models and estimate risk in predefined groups. Results Of 5826 pre‐determined for ostomy self‐care, 4910 (84%) achieved proficiency at discharge, while 916 (16%) did not. Patients of older age, female sex, smokers, higher BMI and ASA scores were more likely not to perform stoma self‐care. Significant treatment factors were the type of surgery, surgical approach and ‘stoma not visible to patient’. The risk model included five dichotomous factors: age ≥ 50, age ≥ 70, ASA score ≥ III, acute surgery and female sex. Each risk factor provided a score of 0 or 1 point, resulting in a maximum of five points for high‐risk patients. The C‐index was 0.66. Conclusion Baseline characteristics, treatment factors and stoma visibility were associated with a reduced likelihood of achieving stoma self‐care proficiency. The risk model, which incorporates readily known variables, may help clinicians identify patients at risk. The model should be further tested in a clinical setting. 10.1111/codi.70382 http://creativecommons.org/licenses/by-nc-nd/4.0/
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spellingShingle Risk factors for not achieving stoma self‐care proficiency at hospital discharge and development of a clinical prediction model: A study based on the Danish Stoma Database
Marianne Krogsgaard
Trine Bolette Borglit
Tobias Wirenfeldt Klausen
Eva Carlsson
Gerd Friis Bille
Bo Marcel Christensen
Ismail Gögenur
Colorectal Disease
Risk factors for not achieving stoma self‐care proficiency at hospital discharge and development of a clinical prediction model: A study based on the Danish Stoma Database Marianne Krogsgaard Trine Bolette Borglit Tobias Wirenfeldt Klausen Eva Carlsson Gerd Friis Bille Bo Marcel Christensen Ismail Gögenur Colorectal Disease Abstract Aim Stoma self‐care is critical for long‐term adaptation. Personalised approaches may help identify patients needing additional guidance during initial admission. This study aimed to examine factors associated with not achieving stoma self‐care proficiency and develop a risk model for use in clinical practice. Method We linked prospective health data from the Danish Stoma Database Capital Region and the Danish Anaesthesia Database. Multiple logistic regression analysis provided risk factors associated with not achieving stoma self‐care proficiency. The C‐statistic was used to evaluate the discriminative ability of logistic regression models. Data were randomly split into training and validation sets to develop models and estimate risk in predefined groups. Results Of 5826 pre‐determined for ostomy self‐care, 4910 (84%) achieved proficiency at discharge, while 916 (16%) did not. Patients of older age, female sex, smokers, higher BMI and ASA scores were more likely not to perform stoma self‐care. Significant treatment factors were the type of surgery, surgical approach and ‘stoma not visible to patient’. The risk model included five dichotomous factors: age ≥ 50, age ≥ 70, ASA score ≥ III, acute surgery and female sex. Each risk factor provided a score of 0 or 1 point, resulting in a maximum of five points for high‐risk patients. The C‐index was 0.66. Conclusion Baseline characteristics, treatment factors and stoma visibility were associated with a reduced likelihood of achieving stoma self‐care proficiency. The risk model, which incorporates readily known variables, may help clinicians identify patients at risk. The model should be further tested in a clinical setting. 10.1111/codi.70382 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Risk factors for not achieving stoma self‐care proficiency at hospital discharge and development of a clinical prediction model: A study based on the Danish Stoma Database
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.70382