Development and validation of a nomogram for surgical site infection after gastrectomy in gastric cancer

Abstract

Background One of the most frequent problems following surgery for stomach cancer is surgical site infection (SSI). Still, a major difficulty is figuring out how to anticipate it and prevent it. The aim of this study was to investigate the risk factors for SSI after gastric cancer surgery and to develop an individualized predictive nomogram. Method Data were collected from 763 gastric cancer patients after surgery in Gansu Provincial People's Hospital and the First Hospital of Lanzhou University (601 cases in the training cohort and 162 cases in the validation cohort). The risk variables of postoperative surgical site infection in gastric cancer were identified using logistic regression, and a nomogram was created. Result Factor analysis showed that age (P = 0.002), operation time (P < 0.001), operation method (P < 0.001), total gastrectomy (P = 0.013), and tumor diameter (P = 0.017) were independent predictors of SSI. The area under the curve of the nomogram training cohort and validation cohort constructed based on the above factors were 0.834 and 0.798, respectively. calibration plots in the validation cohort based on the five predictors showed good agreement between the actual probability and the probability predicted by the column line graph. The model provided good fit and calibration in decision curve analysis with positive net benefit. Conclusions This nomogram has good predictive ability for postoperative SSI in gastric cancer. It can serve as a guide for choosing surgical techniques and perioperative care, and it can offer patients tailored and accurate care.