A Novel Nomogram for Predicting Postsurgical Intra-abdominal Infection in Gastric Cancer Patients: a Prospective Study
A Novel Nomogram for Predicting Postsurgical Intra-abdominal Infection in Gastric Cancer Patients: a Prospective Study
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预测胃癌患者术后腹内感染的新型列线图：一项前瞻性研究
DOI：
10.1007/s11605-017-3580-1
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发表时间：
2018-03-01
影响因子：
3.2
通讯作者：
Shen, Xian
中科院分区：
文献类型：
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作者：
Mao, Chen-chen;Chen, Xiao-dong;Shen, Xian
背景：本研究旨在前瞻性地确定腹内感染（IAI）与肌肉减少症之间的关系，并构建腹内感染（IAI）高危患者的形态图。方法：我们对682例连续行根治性胃切除术的胃癌患者进行了前瞻性研究。术前测量骨骼肌减少因素，包括腰骨骼肌指数、握力和步态速度。通过单因素和多因素分析确定影响IAI的因素。构建由独立危险因素组成的nomogram来量化IAI的个体风险。结果：本研究纳入的682例患者中，132例诊断为肌肉减少症，61例诊断为IAI。Logistic分析显示，肌肉减少症、肿瘤大小、病理类型和多脏器切除是IAI的独立预后因素。IAI的正态图模型能够可靠地量化IAI的风险，具有很强的乐观调整判别（一致性指数，0.736）。结论：肌少症是IAI的独立预测因子。我们的nomographic是一种简单实用的工具，可以量化IAI的个体风险，并可用于识别高风险患者。
Background:This study aimed to determine the relationship between intra-abdominal infection (IAI) and sarcopenia prospectively and to construct a nomogram to identify patients at a high risk of IAI.Methods:We conducted a prospective study of 682 consecutive patients with gastric cancer who underwent radical gastrectomy. The sarcopenia elements, including lumbar skeletal muscle index, handgrip strength, and gait speed, were measured before surgery. Factors contributing to IAI were determined through univariate and multivariate analysis. A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of IAI.Results:Of the 682 patients enrolled in this study, 132 patients were diagnosed with sarcopenia and 61 were diagnosed with IAI. Logistic analysis revealed that sarcopenia, tumor size, pathological type, and multivisceral resection were independent prognostic factors for IAI. The nomogram model for IAI was able to reliably quantify the risk of IAI with a strong optimism-adjusted discrimination (concordance index, 0.736).Conclusions:Sarcopenia is an independent predictor of IAI. Our nomogram was a simple and practical instrument to quantify the individual risk of IAI and could be used to identify patients at a high risk.