Wang Chen, Huang Han-Zhang, He Yu, Yu Yu-Jun, Zhou Qing-Miao, Wang Rong-Jian, He Jian-Bo, Han Shao-Liang
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, People's Republic of China.
Cancer Manag Res. 2020 Feb 7;12:881-889. doi: 10.2147/CMAR.S238530. eCollection 2020.
Our study aimed to construct a visible model to evaluate the risk of infectious complications after gastrectomy.
The clinical data of 856 patients who underwent gastrectomy were used to retrieve medical records. Univariate and multivariate analyses were performed to correlate early postoperative NLR and operative variables with postoperative complications, and the construction of the nomogram was based on logistic regression. The concordance index and receiver operating characteristic curves were used to evaluate the model performance.
The postoperative infectious and noninfectious complication rates after gastrectomy were 18.5% (158/856 cases) and 12.3% (105/856 cases) respectively. Postoperative NLR (within 24 h) independently predicted the development of postoperative infectious complication. Multivariate analysis revealed that age, diabetes, body mass index (BMI), intraoperative blood transfusion and postoperative NLR were independent risk factors. The nomogram model showed a good performance in terms of predicting infectious complications after gastrectomy (concordance index=0.718).
Age, diabetes, BMI, intraoperative blood transfusion and postoperative NLR were independent risk factors of postoperative infectious complications after gastrectomy, and a novel nomogram based on these results can be used to predict postoperative infection and has the advantages of simple application and easy access.
本研究旨在构建一个可视化模型，以评估胃癌切除术后感染性并发症的风险。
采用856例行胃癌切除术患者的临床资料检索病历。进行单因素和多因素分析，以关联术后早期中性粒细胞与淋巴细胞比值（NLR）和手术变量与术后并发症，并基于逻辑回归构建列线图。一致性指数和受试者工作特征曲线用于评估模型性能。
胃癌切除术后感染性和非感染性并发症发生率分别为18.5%（158/856例）和12.3%（105/856例）。术后NLR（24小时内）独立预测术后感染性并发症的发生。多因素分析显示，年龄、糖尿病、体重指数（BMI）、术中输血和术后NLR是独立危险因素。列线图模型在预测胃癌切除术后感染性并发症方面表现良好（一致性指数=0.718）。
年龄、糖尿病、BMI、术中输血和术后NLR是胃癌切除术后感染性并发症的独立危险因素，基于这些结果构建的新型列线图可用于预测术后感染，具有应用简单、易于获取的优点。
