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21 March 2019 : Clinical Research  

Nomogram for Predicting Risk of Intestinal Complications After Colorectal Cancer Surgery

Hui-hong Jiang12ACE, Xian-long Dong12BF, Xuan Tang12BF, A-jian Li12BF, Yi Chang1BF, Hua-guang Li23CD, Ying Chen23DF, Zhi-yong Zhang4AB, Er-jiang Tang23CDE*, Mou-bin Lin12AEG

DOI: 10.12659/MSM.915692

Med Sci Monit 2019; 25:2104-2111

Abstract

BACKGROUND: Intestinal complications are a major cause of morbidity after colorectal cancer surgery. This study aimed to develop an effective nomogram for predicting risk of intestinal complications following colorectal cancer surgery.

MATERIAL AND METHODS: We retrospectively analyzed 1876 patients who underwent colorectal cancer surgery at Yangpu and Zhuji hospitals from January 2013 to October 2018. Intestinal complications were defined as intestinal obstruction, leakage or bleeding, or peritonitis within 30 days after surgery. A logistic regression model was used to identify the risk factors associated with postoperative intestinal complications, and a nomogram for intestinal complications was established. The predictive accuracy of the nomogram was assessed using area under the receiver operating characteristic curve (AUC) and calibration plot.

RESULTS: A total of 164 patients (8.7%) developed intestinal complications after colorectal cancer surgery; 35 (21.3%) of whom died in the postoperative period. Multivariate logistic analysis showed that male gender, history of abdominal surgery, preoperative intestinal obstruction/perforation, metastatic cancer, and lower level of hemoglobin and prognostic nutrition index were independent risk factors (P<0.05 for all). A nomogram was then constructed, and it displayed good accuracy in predicting postoperative intestinal complications with an AUC of 0.76. The calibration plot also showed an excellent agreement between the predicted and observed probabilities.

CONCLUSIONS: We constructed a nomogram based on clinical variables, which could provide individual prediction of postoperative intestinal complications with good accuracy.

Keywords: Colorectal Neoplasms, Intestines, nomograms, Postoperative Complications, Risk Factors, Aged, Aged, 80 and over, Algorithms, Digestive System Surgical Procedures, Forecasting, Intestinal Diseases, Intraoperative Complications, Logistic Models, Middle Aged, Multivariate Analysis, Prognosis, ROC Curve, Retrospective Studies

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750