Chen Ren-Xiong, Wu Zhou-Qiao, Li Zi-Yu, Wang Hong-Zhi, Ji Jia-Fu
ICU, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China.
Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China.
World J Gastrointest Oncol. 2022 Sep 15;14(9):1771-1784. doi: 10.4251/wjgo.v14.i9.1771.
There were few studies on the prognosis of tumor patients with sepsis after gastrointestinal surgery and there was no relevant nomogram for predicting the prognosis of these patients.
To establish a nomogram for predicting the prognosis of tumor patients with sepsis after gastrointestinal surgery in the intensive care unit (ICU).
A total of 303 septic patients after gastrointestinal tumor surgery admitted to the ICU at Peking University Cancer Hospital from January 1, 2013 to December 31, 2020 were analysed retrospectively. The model for predicting the prognosis of septic patients was established by the R software package.
The most common infection site of sepsis after gastrointestinal surgery in the ICU was abdominal infection. The 90-d all-cause mortality rate was 10.2% in our study group. In multiple analyses, we found that there were statistically significant differences in tumor type, septic shock, the number of lymphocytes after ICU admission, serum creatinine and total operation times among tumor patients with sepsis after gastrointestinal surgery ( < 0.05). These five variables could be used to establish a nomogram for predicting the prognosis of these septic patients. The nomogram was verified, and the initial C-index was 0.861. After 1000 internal validations of the model, the C-index was 0.876, and the discrimination was good. The correction curve indicated that the actual value was in good agreement with the predicted value.
The nomogram based on these five factors (tumor type, septic shock, number of lymphocytes, serum creatinine, and total operation times) could accurately predict the prognosis of tumor patients with sepsis after gastrointestinal surgery.
关于胃肠道手术后合并脓毒症的肿瘤患者的预后研究较少，且尚无用于预测这些患者预后的相关列线图。
建立一种列线图，用于预测重症监护病房（ICU）中胃肠道手术后合并脓毒症的肿瘤患者的预后。
回顾性分析2013年1月1日至2020年12月31日北京大学肿瘤医院ICU收治的303例胃肠道肿瘤手术后发生脓毒症的患者。使用R软件包建立脓毒症患者预后预测模型。
ICU中胃肠道手术后脓毒症最常见的感染部位是腹腔感染。本研究组90天全因死亡率为10.2%。在多因素分析中，我们发现胃肠道手术后合并脓毒症的肿瘤患者在肿瘤类型、感染性休克、入住ICU后淋巴细胞计数、血清肌酐和总手术时间方面存在统计学显著差异（<0.05）。这五个变量可用于建立预测这些脓毒症患者预后的列线图。对该列线图进行验证，初始C指数为0.861。对模型进行1000次内部验证后，C指数为0.876，区分度良好。校正曲线表明实际值与预测值吻合良好。
基于肿瘤类型、感染性休克、淋巴细胞计数、血清肌酐和总手术时间这五个因素的列线图可准确预测胃肠道手术后合并脓毒症的肿瘤患者的预后。
