Ba Ming-Qin, Zheng Wen-Lin, Zhang Yu-Ling, Zhang Lin-Lin, Chen Jing-Jing, Ma Jie, Huang Jia-Li
Department of Gastrointestinal Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China (Anhui Provincial Cancer Hospital), Hefei 230031, Anhui Province, China.
World J Gastrointest Surg. 2025 Jan 27;17(1):100547. doi: 10.4240/wjgs.v17.i1.100547.
Postoperative enterostomy is increasing in patients with colorectal cancer, but there is a lack of a model that can predict the probability of early complications.
To explore the factors influencing early postoperative stoma complications in colorectal cancer patients and to construct a nomogram prediction model for predicting the probability of these complications.
A retrospective study of 462 patients who underwent postoperative ostomy for colorectal cancer in the Gastrointestinal Department of the Anhui Provincial Cancer Hospital. The patients' basic information, surgical details, pathological results, and preoperative inflammatory and nutritional indicators were reviewed. We used univariate and multivariate logistic regression to analyze the risk factors for early postoperative stoma complications in colorectal cancer patients and constructed a nomogram prediction model to predict the probability of these complications.
Binary logistic regression analysis revealed that diabetes [odds ratio (OR) = 3.088, 95% confidence interval (CI): 1.419-6.719], preoperative radiotherapy and chemotherapy (OR = 6.822, 95%CI: 2.171-21.433), stoma type (OR = 2.118, 95%CI: 1.151-3.898), Nutritional risk screening 2002 score (OR = 2.034, 95%CI: 1.082-3.822) and prognostic nutritional index (OR = 0.486, 95%CI: 0.254-0.927) were risk factors for early stoma complications after colorectal cancer surgery ( < 0.05). On the basis of these results, a prediction model was constructed and the area under the receiver operating characteristic curve was 0.740 (95%CI: 0.669-0.811). After internal validation, the area under the receiver operating characteristic curve of the validation group was 0.725 (95%CI: 0.631-0.820). The calibration curves for the modeling group and validation group are displayed. The predicted results have a good degree of overlap with the actual results.
A previous history of diabetes, preoperative radiotherapy and chemotherapy, stoma type, Nutritional risk screening 2002 score and prognostic nutritional index are risk factors for early stoma complications after colorectal cancer surgery. The nomogram prediction model constructed on the basis of the results of logistic regression analysis in this study can effectively predict the probability of early stomal complications after colorectal cancer surgery.
结直肠癌患者术后肠造口术的应用日益增多，但缺乏能够预测早期并发症发生概率的模型。
探讨影响结直肠癌患者术后早期造口并发症的因素，并构建列线图预测模型以预测这些并发症的发生概率。
对安徽省肿瘤医院胃肠外科462例行结直肠癌术后造口术的患者进行回顾性研究。回顾患者的基本信息、手术细节、病理结果以及术前炎症和营养指标。采用单因素和多因素logistic回归分析结直肠癌患者术后早期造口并发症的危险因素，并构建列线图预测模型以预测这些并发症的发生概率。
二元logistic回归分析显示，糖尿病[比值比（OR）=3.088，95%置信区间（CI）：1.419 - 6.719]、术前放化疗（OR = 6.822，95%CI：2.171 - 21.433）、造口类型（OR = 2.118，95%CI：1.151 - 3.898）、营养风险筛查2002评分（OR = 2.034，95%CI：1.082 - 3.822）和预后营养指数（OR = 0.486，95%CI：0.254 - 0.927）是结直肠癌手术后早期造口并发症的危险因素（<0.05）。基于这些结果构建了预测模型，受试者操作特征曲线下面积为0.740（95%CI：0.669 - 0.811）。内部验证后，验证组受试者操作特征曲线下面积为0.725（95%CI：0.631 - 0.820）。展示了建模组和验证组的校准曲线。预测结果与实际结果有较好的重叠度。
糖尿病病史、术前放化疗、造口类型、营养风险筛查2002评分和预后营养指数是结直肠癌手术后早期造口并发症的危险因素。基于本研究logistic回归分析结果构建的列线图预测模型能够有效预测结直肠癌手术后早期造口并发症的发生概率。
