Kang Bing, Liu Xiao-Yu, Cheng Yu-Xi, Tao Wei, Peng Dong
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Department of Clinical Nutrition, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
World J Gastrointest Surg. 2022 Aug 27;14(8):743-753. doi: 10.4240/wjgs.v14.i8.743.
Previous studies reported hypertension remission after gastrectomy for gastric cancer patients, and the remission rate was 11.1%-93.8%. We have reported the factors of hypertension remission previously, however, the follow-up time was six months. It is necessary to identify risk factors for hypertension for a relatively longer follow-up time.
To analyze the predictive factors for hypertension remission one year after gastrectomy of gastric cancer patients and to construct a risk model for hypertension remission.
We retrospectively collected the medical information of patients with concurrent gastric cancer and hypertension in a single clinical center from January 2013 to December 2020. Univariate and multivariate logistic regression of hypertension remission were conducted, and a nomogram model was established.
A total of 209 patients with concurrent gastric cancer and hypertension were included in the current study. There were 108 patients in the remission group and 101 patients in the non-remission group. The hypertension remission rate was 51.7% one year after gastrectomy. The remission group had younger aged patients ( = 0.001), larger weight loss ( = 0.001), lower portion of coronary heart disease ( = 0.017), higher portion of II-degree hypertension ( = 0.033) and higher portion of total gastrectomy ( = 0.008) than the non-remission group. Younger age ( = 0.011, odds ratio = 0.955, 95%CI: 0.922-0.990), higher weight loss ( = 0.019, odds ratio = 0.937, 95%CI: 0.887-0.989) and total gastrectomy ( = 0.039, odds ratio = 2.091, 95%CI: 1.037-4.216) were independent predictors for hypertension remission. The concordance index of the model was 0.769 and the calibration curve suggested great agreement. Furthermore, decision curve analysis showed that the model was clinically useful.
Younger age, higher weight loss and total gastrectomy were independent predictors for hypertension remission after gastrectomy for gastric cancer patients. The nomogram could visually display these results.
既往研究报道了胃癌患者胃切除术后高血压缓解情况,缓解率为11.1%-93.8%。我们之前已报道过高血压缓解的相关因素,但随访时间为6个月。有必要针对相对更长的随访时间确定高血压的危险因素。
分析胃癌患者胃切除术后1年高血压缓解的预测因素,并构建高血压缓解风险模型。
我们回顾性收集了2013年1月至2020年12月在单个临床中心同时患有胃癌和高血压患者的医疗信息。对高血压缓解情况进行单因素和多因素逻辑回归分析,并建立列线图模型。
本研究共纳入209例同时患有胃癌和高血压的患者。缓解组108例,未缓解组101例。胃切除术后1年高血压缓解率为51.7%。与未缓解组相比,缓解组患者年龄更小(P=0.001)、体重减轻更多(P=0.001)、冠心病比例更低(P=0.017)、二级高血压比例更高(P=0.033)、全胃切除术比例更高(P=0.008)。年龄较小(P=0.011,比值比=0.955,95%可信区间:0.922-0.990)、体重减轻更多(P=0.019,比值比=0.937,95%可信区间:0.887-0.989)和全胃切除术(P=0.039,比值比=2.091,95%可信区间:1.037-4.216)是高血压缓解的独立预测因素。模型的一致性指数为0.769,校准曲线显示一致性良好。此外,决策曲线分析表明该模型具有临床实用性。
年龄较小、体重减轻更多和全胃切除术是胃癌患者胃切除术后高血压缓解的独立预测因素。列线图可直观显示这些结果。