Chen Xiao-Dong, Mao Chen-Chen, Zhang Wei-Teng, Lin Ji, Wu Rui-Sen, Zhang Feng-Min, Sun Xiang-Wei, Chi Chu-Huai, Shen Xian, Wang Peng-Fei
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
J Surg Oncol. 2017 Sep;116(4):533-544. doi: 10.1002/jso.24691. Epub 2017 Jul 25.
The study aimed to investigate the relationship between obesity and postsurgical gastroparesis syndrome (PGS), and to construct a scoring system and a risk model to identify patients at high risk.
A total of 634 patients were retrospectively analyzed. Clinical characteristics were evaluated via receiver operating characteristic (ROC) curve analysis. Logistic analysis was performed to determine the independent predictive indicators of PGS. A scoring system consisting of these indicators and a risk-rating model were constructed and evaluated via ROC curve analysis.
Based on the ROC curves, the visceral fat area (VFA) cutoff value for PGS was 94.00. Logistic analysis showed that visceral obesity (VFA ≥ 94.00 cm ), the reconstruction technique, and tumor size were independent prognostic factors for PGS. The scoring system could predict PGS reliably with a high area under the ROC curve ([AUC] = 0.769). A high-risk rating had a high AUC (AUC I = 0.56, AUC II = 0.65, and AUC III = 0.77), indicating that the risk-rating model could effectively screen patients at high risk of PGS.
Visceral obesity defined by VFA effectively predicted PGS. Our scoring system may be a reliable instrument for identifying patients most at risk of PGS.
本研究旨在探讨肥胖与术后胃轻瘫综合征(PGS)之间的关系,并构建一个评分系统和风险模型以识别高危患者。
对634例患者进行回顾性分析。通过受试者操作特征(ROC)曲线分析评估临床特征。进行逻辑分析以确定PGS的独立预测指标。构建由这些指标组成的评分系统和风险评级模型,并通过ROC曲线分析进行评估。
根据ROC曲线,PGS的内脏脂肪面积(VFA)截断值为94.00。逻辑分析表明,内脏肥胖(VFA≥94.00 cm²)、重建技术和肿瘤大小是PGS的独立预后因素。该评分系统能够可靠地预测PGS,ROC曲线下面积较高([AUC]=0.769)。高风险评级具有较高的AUC(AUC I=0.56,AUC II=0.65,AUC III=0.77),表明风险评级模型能够有效筛查PGS高危患者。
由VFA定义的内脏肥胖可有效预测PGS。我们的评分系统可能是识别PGS高危患者的可靠工具。