Background:Esophagectomy remains a procedure with one of the highest complication rates.This study aimed to develop and validate a model of nomogram for predicting the probability serious postoperative complications f...Background:Esophagectomy remains a procedure with one of the highest complication rates.This study aimed to develop and validate a model of nomogram for predicting the probability serious postoperative complications for the postoperative esophageal cancer(EC)patients.Methods:An observational study was conducted at Daping Hospital,China,encompassing 529 postoperative EC patients from December 2014 to November 2023.Weintegrated independent prognostic factors to craft a predictivemodel,specifically a nomogram,designed to forecast the risk of severe postoperative complications.Results:The incidence of serious complications for postoperative EC patients was 58.1%.A total of seven variables,including age,gender,bleeding volume during the operation(P=0.035),operating time(P=0.031),the Nutritional Risk Screening 2002(NRS 2002)score(P=0.027),the perioperative nutrition screen(PONS)score(P=0.018),and cystatin C levels(P<0.001),were applied to draw the nomogram of predicting serious complications after esophagectomy.The accuracy of predictive value for the model was quantified by Harrell’s C index at 0.690(95%confidence interval=0.596-0.785,P<0.001).Conclusion:We developed a nomogram system to demonstrate exceptional predictive capabilities for postoperative EC patients in forecasting the risk of serious complications.These results also emphasize the predictive value of the preoperative nutritional risk screening with NRS 2002 and PONS in EC patients undergoing esophagectomy.展开更多
Background Patients with advanced cancer often present with malnutrition.Globally,minority populations frequently suffer from higher rates of malnutrition than the majority group.It was unknown whether the nutritional...Background Patients with advanced cancer often present with malnutrition.Globally,minority populations frequently suffer from higher rates of malnutrition than the majority group.It was unknown whether the nutritional status of cancer patients is different between ethicality groups(i.e.Uyghur and Han)in China.Methods A total of 251 Uyghur cancer patients were enrolled from the Xinjiang Kashgar First People's Hospital in the INSCOC Program.The Han patients were 1∶1 matched to Uyghur patients by age,gender and type of cancer from 72 hospitals around China in INSCOC Program.The nutritional risk and nutritional status were assessed using the Nutrition Risk Screening 2002(NRS 2002)and Patient-Generated Subjective Global Assessment(PG-SGA),respectively.Then,the functional status of cancer patients was determined based on the Karnofsky Performance Status(KPS).Results The incidence of an abnormal NRS-2002(≥3),PG-SGA(≥4),and KPS(≤70)was significantly different(86.1%vs 59.0%,70.5%vs 27.5%,and 18.7%vs 4.0%,respectively P<0.05).The abnormal rate of laboratory indicators in Uyghur cancer patients was significantly higher than that in Han cancer patients,including total protein,albumin,serum total bilirubin,direct bilirubin,HDL-C,white blood cell,lymphocyte,red blood cell,and platelet(all P<0.05).The abnormal rates of TSF,HGS and CC were significantly higher than that of Han nationality patients(17.5%vs 9.7%,39.6%vs 19.6%,29.1%vs 15.2%,P<0.001).The nutritional support rate of Uyghur patients was lower than that of Han patients(0%vs 16.3%).After adjusting for potential risk factors,malnutrition was associated with gender(female,OR=0.35,95%CI=0.13-0.92,P=0.034),age(>60 years,OR=5.32,95%CI=1.46-19.41,P=0.011),cancer type(gastroesophageal tumor,OR=33.62,95%CI=3.42-330.67,P=0.003),and treatment methods(received radical tumor resection,OR=5.78,95%CI=1.45-23.08,P=0.008;received radiotherapy or chemotherapy:OR=7.69,95%CI=2.27-26.04,P<0.001).Conclusions The nutritional status of Uyghur cancer patients is worse than that of Han patients and the Uyghur patients with poor nutritional status lack the necessary nutritional support.展开更多
基金the Key Program of Chongqing Municipal Science and Health Joint Medical Research Project(No.2024DBXM005)the Chongqing Municipal Health Commission Medical Science Research Project(No.2024WSJK024).
文摘Background:Esophagectomy remains a procedure with one of the highest complication rates.This study aimed to develop and validate a model of nomogram for predicting the probability serious postoperative complications for the postoperative esophageal cancer(EC)patients.Methods:An observational study was conducted at Daping Hospital,China,encompassing 529 postoperative EC patients from December 2014 to November 2023.Weintegrated independent prognostic factors to craft a predictivemodel,specifically a nomogram,designed to forecast the risk of severe postoperative complications.Results:The incidence of serious complications for postoperative EC patients was 58.1%.A total of seven variables,including age,gender,bleeding volume during the operation(P=0.035),operating time(P=0.031),the Nutritional Risk Screening 2002(NRS 2002)score(P=0.027),the perioperative nutrition screen(PONS)score(P=0.018),and cystatin C levels(P<0.001),were applied to draw the nomogram of predicting serious complications after esophagectomy.The accuracy of predictive value for the model was quantified by Harrell’s C index at 0.690(95%confidence interval=0.596-0.785,P<0.001).Conclusion:We developed a nomogram system to demonstrate exceptional predictive capabilities for postoperative EC patients in forecasting the risk of serious complications.These results also emphasize the predictive value of the preoperative nutritional risk screening with NRS 2002 and PONS in EC patients undergoing esophagectomy.
基金supported by Henan University Science and Technology Innovation Talents Support Program(19HASTIT005)the National Key Research and Development Program(No.2017YFC1309200)the Medical Science and Technology Key Projects of Henan Province and Zhengzhou(192102310088,19A32000820).
文摘Background Patients with advanced cancer often present with malnutrition.Globally,minority populations frequently suffer from higher rates of malnutrition than the majority group.It was unknown whether the nutritional status of cancer patients is different between ethicality groups(i.e.Uyghur and Han)in China.Methods A total of 251 Uyghur cancer patients were enrolled from the Xinjiang Kashgar First People's Hospital in the INSCOC Program.The Han patients were 1∶1 matched to Uyghur patients by age,gender and type of cancer from 72 hospitals around China in INSCOC Program.The nutritional risk and nutritional status were assessed using the Nutrition Risk Screening 2002(NRS 2002)and Patient-Generated Subjective Global Assessment(PG-SGA),respectively.Then,the functional status of cancer patients was determined based on the Karnofsky Performance Status(KPS).Results The incidence of an abnormal NRS-2002(≥3),PG-SGA(≥4),and KPS(≤70)was significantly different(86.1%vs 59.0%,70.5%vs 27.5%,and 18.7%vs 4.0%,respectively P<0.05).The abnormal rate of laboratory indicators in Uyghur cancer patients was significantly higher than that in Han cancer patients,including total protein,albumin,serum total bilirubin,direct bilirubin,HDL-C,white blood cell,lymphocyte,red blood cell,and platelet(all P<0.05).The abnormal rates of TSF,HGS and CC were significantly higher than that of Han nationality patients(17.5%vs 9.7%,39.6%vs 19.6%,29.1%vs 15.2%,P<0.001).The nutritional support rate of Uyghur patients was lower than that of Han patients(0%vs 16.3%).After adjusting for potential risk factors,malnutrition was associated with gender(female,OR=0.35,95%CI=0.13-0.92,P=0.034),age(>60 years,OR=5.32,95%CI=1.46-19.41,P=0.011),cancer type(gastroesophageal tumor,OR=33.62,95%CI=3.42-330.67,P=0.003),and treatment methods(received radical tumor resection,OR=5.78,95%CI=1.45-23.08,P=0.008;received radiotherapy or chemotherapy:OR=7.69,95%CI=2.27-26.04,P<0.001).Conclusions The nutritional status of Uyghur cancer patients is worse than that of Han patients and the Uyghur patients with poor nutritional status lack the necessary nutritional support.
