Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram
BackgroundPostoperative pulmonary complications (PPCs) are common in gastric cancer patients after gastrectomy. The aim of our study was to investigate the perioperative risk factors and to develop a nomogram to identify patients who are at significant risk of PPCs.MethodsThe clinical data of gastri...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-12-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1308591/full |
| _version_ | 1797384185295405056 |
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| author | Ling Zhou Yuanna Li Yuanbo Ni Cunming Liu |
| author_facet | Ling Zhou Yuanna Li Yuanbo Ni Cunming Liu |
| author_sort | Ling Zhou |
| collection | DOAJ |
| description | BackgroundPostoperative pulmonary complications (PPCs) are common in gastric cancer patients after gastrectomy. The aim of our study was to investigate the perioperative risk factors and to develop a nomogram to identify patients who are at significant risk of PPCs.MethodsThe clinical data of gastric cancer patients who underwent elective gastrectomy in the First Affiliated Hospital of Nanjing Medical University from 2017 to 2021 were retrospectively collected. All patients were randomly divided into a training and a validation cohort at a ratio of 7:3. Univariate and multivariate analysis were applied to identify the independent risk factors that might predict PPCs, and a nomogram was constructed. Both discrimination and calibration abilities were estimated by the area under a receiver operating characteristic curve (AUC) and calibration curves. The clinical effectiveness of the nomogram was further quantified with the decision curve analysis (DCA).ResultsOf 2,124 included patients, one hundred and fifty patients (7.1%) developed PPCs. Binary logistic analysis showed that age > 65 years, higher total cholesterol level, longer duration of surgery, total gastrectomy, and the dose of oxycodone > 5.5 mg were independent risk factors for the occurrence of PPCs, which were contained in the nomogram. The predictive nomogram showed good discrimination and calibration [an AUC of 0.735 (95% CI: 0.687–0.783) in a training cohort and 0.781 (95% CI: 0.715–0.847) in a validation cohort]. The calibration curve and decision curve analysis showed a good agreement between nomogram predictions and actual observations.ConclusionWe developed a nomogram model based on age, total cholesterol, extent of resection, duration of surgery, and the dose of oxycodone to predict the risk of PPCs in gastric cancer patients after elective gastrectomy. |
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| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-08T21:31:51Z |
| publishDate | 2023-12-01 |
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| series | Frontiers in Surgery |
| spelling | doaj.art-08666c24f80f4e0f92d04a615f99a6292023-12-21T04:54:31ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-12-011010.3389/fsurg.2023.13085911308591Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogramLing ZhouYuanna LiYuanbo NiCunming LiuBackgroundPostoperative pulmonary complications (PPCs) are common in gastric cancer patients after gastrectomy. The aim of our study was to investigate the perioperative risk factors and to develop a nomogram to identify patients who are at significant risk of PPCs.MethodsThe clinical data of gastric cancer patients who underwent elective gastrectomy in the First Affiliated Hospital of Nanjing Medical University from 2017 to 2021 were retrospectively collected. All patients were randomly divided into a training and a validation cohort at a ratio of 7:3. Univariate and multivariate analysis were applied to identify the independent risk factors that might predict PPCs, and a nomogram was constructed. Both discrimination and calibration abilities were estimated by the area under a receiver operating characteristic curve (AUC) and calibration curves. The clinical effectiveness of the nomogram was further quantified with the decision curve analysis (DCA).ResultsOf 2,124 included patients, one hundred and fifty patients (7.1%) developed PPCs. Binary logistic analysis showed that age > 65 years, higher total cholesterol level, longer duration of surgery, total gastrectomy, and the dose of oxycodone > 5.5 mg were independent risk factors for the occurrence of PPCs, which were contained in the nomogram. The predictive nomogram showed good discrimination and calibration [an AUC of 0.735 (95% CI: 0.687–0.783) in a training cohort and 0.781 (95% CI: 0.715–0.847) in a validation cohort]. The calibration curve and decision curve analysis showed a good agreement between nomogram predictions and actual observations.ConclusionWe developed a nomogram model based on age, total cholesterol, extent of resection, duration of surgery, and the dose of oxycodone to predict the risk of PPCs in gastric cancer patients after elective gastrectomy.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1308591/fullgastrectomyrisk factorsnomogramstate of nutritioncomplications |
| spellingShingle | Ling Zhou Yuanna Li Yuanbo Ni Cunming Liu Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram Frontiers in Surgery gastrectomy risk factors nomogram state of nutrition complications |
| title | Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram |
| title_full | Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram |
| title_fullStr | Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram |
| title_full_unstemmed | Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram |
| title_short | Analysis of postoperative pulmonary complications after gastrectomy for gastric cancer: development and validation of a nomogram |
| title_sort | analysis of postoperative pulmonary complications after gastrectomy for gastric cancer development and validation of a nomogram |
| topic | gastrectomy risk factors nomogram state of nutrition complications |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1308591/full |
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