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从原始炎症评分中获得的一个新的降维变量与结直肠癌根治性手术后的发病率高度相关。

A new dimensional-reducing variable obtained from original inflammatory scores is highly associated to morbidity after curative surgery for colorectal cancer.

作者信息

Bailon-Cuadrado Martin, Perez-Saborido Baltasar, Sanchez-Gonzalez Javier, Rodriguez-Lopez Mario, Mayo-Iscar Agustin, Pacheco-Sanchez David

机构信息

General and Digestive Surgery Department, Rio Hortega University Hospital, C/ Dulzaina, n° 2, 47012, Valladolid, Spain.

Statistics Department, University of Valladolid, Valladolid, Spain.

出版信息

Int J Colorectal Dis. 2018 Sep;33(9):1225-1234. doi: 10.1007/s00384-018-3100-0. Epub 2018 Jun 20.

DOI:10.1007/s00384-018-3100-0
PMID:29926232
Abstract

PURPOSE

Several scores have been developed to define the inflammatory status of oncological patients. We suspect they share iterative information. Our hypothesis is that we may summarise their information into one or two new variables which will be independent. This will help us to predict, more accurately, which patients are at an increased risk of suffering postoperative complications after curative surgery for CRC.

METHODS

Observational prospective study with those patients undergoing curative surgery for CRC between September 2015 and February 2017. We analysed the influence of inflammatory scores (PNI, GPS, NLR, PLR) on postoperative morbidity (overall and severe complications, anastomotic leakage and reoperation).

RESULTS

Finally, 168 patients were analysed. We checked these four original scores are interrelated among them. Using a complex and innovative statistical method, we created two new independent variables (resultant A and resultant B) which resume the information coming from them. One of these two new variables (resultant A) was statistically associated to overall complications (OR, 2.239; 95% CI, 1.541-3.253; p = 0.0001), severe complications (OR, 1.773; 95% CI, 1.129-2.785; p = 0.013), anastomotic leakage (OR, 3.208; 95% CI, 1.416-7.268; p = 0.005) and reoperation (OR, 2.349; 95% CI, 1.281-4.305; p = 0.006).

CONCLUSIONS

We evinced the four original scores we used share redundant information. We created two new independent new variables which resume their information. In our sample of patients, one of these variables turned out to be a great predictive factor for the four complications we analysed.

摘要

目的

已开发出多种评分系统来定义肿瘤患者的炎症状态。我们怀疑它们存在重复信息。我们的假设是,我们可以将它们的信息总结为一两个新的独立变量。这将有助于我们更准确地预测哪些患者在接受结直肠癌根治性手术后发生术后并发症的风险增加。

方法

对2015年9月至2017年2月期间接受结直肠癌根治性手术的患者进行观察性前瞻性研究。我们分析了炎症评分(PNI、GPS、NLR、PLR)对术后发病率(总体和严重并发症、吻合口漏和再次手术)的影响。

结果

最终分析了168例患者。我们检查发现这四个原始评分相互关联。使用一种复杂且创新的统计方法,我们创建了两个新的独立变量(结果A和结果B),它们概括了来自原始评分的信息。这两个新变量之一(结果A)与总体并发症(OR,2.239;95%CI,1.541 - 3.253;p = 0.0001)、严重并发症(OR,1.773;95%CI,1.129 - 2.785;p = 0.013)、吻合口漏(OR,3.208;95%CI,1.416 - 7.268;p = 0.005)和再次手术(OR,2.349;95%CI,1.281 - 4.305;p = 0.006)在统计学上相关。

结论

我们证明了我们使用的四个原始评分存在冗余信息。我们创建了两个新的独立变量来概括它们的信息。在我们的患者样本中,其中一个变量被证明是我们分析的四种并发症的重要预测因素。

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Int J Colorectal Dis. 2017 Jun;32(6):805-811. doi: 10.1007/s00384-017-2811-y. Epub 2017 Apr 14.
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ESPEN guideline: Clinical nutrition in surgery.ESPEN 指南:外科手术中的临床营养。
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