个体化预测结肠癌术后发生并发症风险列线图模型的建立

Establishment of a personalized nomogram model for predicting the risk of postoperative complications in patients with colon cancer

目的:建立个体化预测结肠癌术后发生并发症风险的列线图模型。方法:回顾性分析2018—2019年在我院行手术治疗的342例结肠癌患者的临床资料,根据是否发生并发症分为发生并发症组(n=88)与未发生并发症组(n=254),筛选出影响结肠癌患者术后发生并发症的危险因素,建立风险预测模型并进行验证。结果:年龄>60岁、糖尿病史、营养评分≥4分、手术时间≥3 h及住院时间≥30 d为结肠癌患者术后发生并发症的独立危险因素。模型的预测值与实测值基本一致,表明该列线图具有良好的预测能力;C-index指数高达0.813,表明该列线图具有较高的精准度与区分度。结论:对于结肠癌患者,应充分考虑年龄、糖尿病史、营养评分、手术时间及住院时间对术后发生并发症的影响,采用列线图进行个体化预测,并采取相应干预措施,以降低术后并发症的发生率。

Objective:To establish an personalized nomogram model for predicting the risk of complications after colon cancer surgery.Methods:A retrospective analysis was conducted on the clinical data of 342 patients with colon cancer who underwent surgical treatment in our hospital from 2018 to 2019.They were divided into the complication group(n=88)and the noncomplication group(n=254)based on whether complications occurred.Risk factors affecting the occurrence of postoperative complications in patients with colon cancer were screened,and a risk prediction model was established and validated.Results:Age>60 years old,history of diabetes,nutritional score≥4 points,operation time≥3 hours,and hospital stay≥30 days were independent risk factors for postoperative complications of patients with colon cancer.The predicted values of the model were basically consistent with the measured values,indicating that this nomogram had good predictive ability.The C-index index was as high as O.813,indicating that this nomogram had high accuracy and discrimination.Conclusion:For patients with colon cancer,the influence of age,history of diabetes,nutritional score,operation time,and hospital stay on postoperative complications should be fully considered.The nomogram should be used for individualized prediction,and corresponding intervention measures should be taken to reduce the incidence of postoperative complications.