General Surgery Department, Dandong Central Hospital, China Medical University, Dandong, Liaoning, China.
Orthopedics Department, Dandong Central Hospital, China Medical University, Dandong, Liaoning, China.
Medicine (Baltimore). 2024 Mar 15;103(11):e37489. doi: 10.1097/MD.0000000000037489.
Gastric cancer (GC) is one of the most common malignant tumors worldwide and the fourth leading cause of cancer-related deaths, with a relatively high incidence among the elderly population. Surgical resection is the mainstay treatment for GC and is currently the only cure. However, the incidence of postoperative intraabdominal infections remains high and seriously affects the prognosis. This study aimed to explore the risk factors for intraabdominal infections after radical gastrectomy in elderly patients and to establish and validate a risk prediction model. We collected the clinical data of 322 GC patients, who underwent radical gastrectomy at the General Surgery Department of China Medical University Dandong Central Hospital from January 2016 to January 2023. The patients were divided into an infected group (n = 27) and a noninfected group (n = 295) according to whether intraabdominal infections occurred postoperatively. A nomogram risk prediction model for the occurrence of postoperative intraabdominal infections was developed. All patients were randomized into a training set (n = 225) and a validation set (n = 97) in a 7:3 ratio, and the model was internally validated. Of the 322 patients, 27 (8.3%) experienced postoperative intraabdominal infections. Single-factor analysis revealed associations of intraabdominal infection with body mass index, glucose, hemoglobin, albumin, and other factors. The multifactorial analysis confirmed that body mass index, glucose, hemoglobin, albumin, surgical duration, and bleeding volume were independent risk factors for intraabdominal infections. The nomogram constructed based on these factors demonstrated excellent performance in both the training and validation sets. A nomogram model was developed and validated to predict the risk of intraabdominal infection after radical gastrectomy. The model has a good predictive performance, which could help clinicians prevent the occurrence of intraabdominal infections after radical gastrectomy in elderly patients.
胃癌(GC)是全球最常见的恶性肿瘤之一,也是癌症相关死亡的第四大主要原因,在老年人群中发病率相对较高。手术切除是 GC 的主要治疗方法,也是目前唯一的治愈方法。然而,术后腹腔内感染的发生率仍然较高,严重影响预后。本研究旨在探讨老年患者根治性胃切除术后腹腔内感染的危险因素,并建立和验证风险预测模型。我们收集了中国医科大学附属丹东中心医院普外科 2016 年 1 月至 2023 年 1 月收治的 322 例 GC 患者的临床资料。根据术后是否发生腹腔内感染,将患者分为感染组(n=27)和非感染组(n=295)。建立并验证了术后腹腔内感染发生的列线图风险预测模型。所有患者按 7:3 的比例随机分为训练集(n=225)和验证集(n=97),并进行内部验证。322 例患者中,27 例(8.3%)发生术后腹腔内感染。单因素分析显示,腹腔内感染与体重指数、血糖、血红蛋白、白蛋白等因素有关。多因素分析证实,体重指数、血糖、血红蛋白、白蛋白、手术时间和出血量是腹腔内感染的独立危险因素。基于这些因素构建的列线图在训练集和验证集均表现出良好的性能。本研究建立并验证了预测根治性胃切除术后腹腔内感染风险的列线图模型。该模型具有良好的预测性能,有助于临床医生预防老年患者根治性胃切除术后腹腔内感染的发生。