Multivariate logistic regression analysis of postoperative complications and risk model establishment of gastrectomy for gastric cancer: A single-center cohort report

Miranda

et al. 2017

An Sist Sanit Navar

Fundamento. En publicaciones asiáticas se postula que un Índice de Onodera (IO) bajo puede asociarse con una mayor frecuencia de complicaciones post-resección radical del cáncer gástrico, careciendo de resultados en áreas occidentales. En el presente trabajo se analiza la relación entre un IO pre-operatorio bajo con la frecuencia y la gravedad de las complicaciones post-cirugía R0 en el cáncer gástrico.Pacientes y métodos. Se revisaron 124 tumores gástricos con resección R0. Considerando patológicamente bajo un IO <45, estudiamos la frecuencia de complicaciones entre los grupos con IO menor y ≥45. En el análisis multivariante incluimos como variables de ajuste la edad mayor de 68 años, puntuación ASA, hemoglobina pre-operatoria menor de 12 g/dL, estadio pTNM, administración o no de tratamiento neoadyuvante y tipo de gastrectomía realizada. Determinamos la relación entre IO <45 y la frecuencia y gravedad de las complicaciones, según la clasificación de Clavien-Dindo modificada.resultados. Se registraron complicaciones leves en un 11,3%; graves 9,7% y exitus 2,4%. Los pacientes con IO <45 presentaron mayor frecuencia de complicaciones: 37,7% versus 12,7% [ odds ratio ( conclusiones. También en un país occidental, los pacientes con IO pre-operatorio bajo (<45) muestran un mayor riesgo independiente de presentar complicaciones tras la resección R0 del carcinoma gástrico. Adicionalmente, las complicaciones registradas en los casos con IO <45, muestran una significativa mayor gravedad. aBstractBackground. It has been postulated in the Asian literature that a low prognostic nutritional index (OI) could be associated with a higher rate of complications following radical gastric cancer surgery, but there is a lack of data concerning western countries. The aim is to analyze the relationship between a low preoperative OI and the frequency and severity of surgical complications in R0 gastric cancer resection. Patients and methods.In the present article, 124 cases of gastric cancer with R0 resection were reviewed. An OI <45 was considered pathologically low. The complication rate was compared between both groups: OI <45 vs OI ≥45. A multivariate analysis was performed adjusting for: age > 68 years, ASA score, preoperative hemoglobin level <12 g/dL, pTNM stage, administration of neoadyuvant therapy and type of gastrectomy. The relationship between a PNI<45 and the severity of complications graded according to the Clavien-Dindo classification was determined.results. We registered mild complications in 11.3% of cases, severe complications in 9.7% and a mortality rate of 2.4%. Patients with a OI <45 showed a higher complication rate: 37.7% versus 12. conclusions. We confirmed that patients with a low preoperative OI show a higher independent risk of complications after a R0 gastric cancer resection in a western country as well. Complications, in these cases with OI <45, registered a significantly higher severity grade.

Section: Resultsunclassified

Relation between preoperative prognostic Onodera’s Index and postsurgery complications in the R0 gastric carcinoma resection

Miranda

et al. 2017

An Sist Sanit Navar

Saudi Journal of Biological Sciences

“…Logistic regression has three main purposes: risk factor search, predictions and judgments. As one of the most widely used statistical methods in medicine, Logistic regression is the most commonly used models in prediction of complications, such as prediction of risk in surgical complications of gastric cancer (Zhou et al, 2016), prostate biopsy factors and prostate cancer prediction (Li et al, 2015). In the present study, by Logistic regression analysis, 6 biochemical indexes of Hcy, IL-6, Hs-CRP, DD, CysC and MDA were incorporated in the equation, with respective partial regression coefficients at 0.275, 1.202, 0.065, 1.989, 9.724 and 3.407.…”

Section: Discussionmentioning

confidence: 99%

Modeling analysis of the relationship between atherosclerosis and related inflammatory factors

Zhang

Yuan

et al. 2017

To establish early diagnosis model of inflammatory factors for atherosclerosis (AS), providing theoretical evidence for early detection of AS and development of plaques. Serum samples were collected to detect the inflammatory factors including CysC, Hcy, hs-CRP, UA, FIB, D-D, LP (a), IL-6, SAA, sCD40L and MDA. Using Logistic regression analysis, the inflammatory factors used for modeling were screened out, and then the AS early diagnosis models were established based on receiver operating characteristic (ROC) curve, support vector machine and BP neural network respectively. No significant difference exists between the general materials of two groups. All 11 inflammatory factors had higher level in AS group than in control group. As shown in ROC curve, all inflammatory factors were helpful in AS diagnosis. In terms of sensitivity, UA ranked first (98) and FIB ranked last (55.5); in terms of specificity, UA ranked first (99) and FIB ranked last (78); in terms of area under the curve, UA and SAA ranked first (both were 0.995) and FIB ranked last (0.721). Based on Logistic regression equation, six factors were screened out, including Hcy, Hs-CRP, IL-6, D-D, CysC and MDA. According to classification, the final sixth steps had a prediction accuracy of 99%. When six inflammatory factors included in Logistic regression equation were detected jointly, the sensitivity, specificity and area under the curve were 57%, 97% and 0.821 respectively, while those of the model excluding D-D were 64%, 90% and 0.828, generally superior to results of joint detection including six factors. The ROC curve based on Hcy, Hs-CRP and MDA had a sensitivity of 87%, a specificity of 94% and an area under the curve of 0.869, being inferior to those of the ROC curve based on IL-6, D-D and Cys C, which were 87%, 92% and 0.936 respectively. The accuracy of SVM-AS diagnosis model and BP neural network model were 82.5% and 77.5% respectively. All 11 inflammatory factors are valuable in AS diagnosis. AS early diagnosis models based on Logistic regression analysis, ROC curve, support vector machine and BP neural network possess diagnostic value and can provide reference for clinical diagnosis.

“…There were no grade IV and V complications in the two groups because of the small statistical samples. Zhou J and other scholars believe that malnutrition is an important factor leading to postoperative complications and higher CDCS grade [22]. In patients with malnutrition, the body is in a state of nutritional risk, and a series of compensatory changes will appear in the organs and tissues of the whole body to adapt to this state, such as decreased muscle strength, prolonged recovery time of the whole body and wound, decreased immunity, delayed wound healing, weakened function of neutrophils, macrophages and lymphocytes [23].…”

Section: The Relationship Between Nutritional Status and Postoperative Complications In Pca Patientsmentioning

confidence: 95%

Preoperative Nutritional Evaluation of Elderly Patients with Prostate Cancer Undergoing Laparoscopic Radical Prostatectomy

Wang

Fan

et al. 2021

Preprint

Objective The purpose of this study is to evaluate the association and predictive value of geriatric nutritional risk index (GNRI) in elderly patients with prostate cancer(PCa) undergoing laparoscopic radical prostatectomy (LRP). Methods the clinical data of 72 elderly patients (aged ≥ 65 y) with PCa undergoing LRP in the Department of Urology, Affiliated Hospital of North Sichuan Medical College from January 2018 to December 2020 were retrospectively analyzed. The basic information, laboratory examination indexes, operation conditions, postoperative complications and postoperative recovery indexes of patients were included. Clavien-Dindo Classification System (CDCS) was used to assess the postoperative complications. T-test was used to analyze the grouping variables. ROC curve was drawn to study the predictive value of GNRI for postoperative complications. Results The body weight, BMI, preoperative HGB, ALB values of malnutrition group (MNg) and normal nutrition group (NNg) were significantly positively correlated (P༜0.01); the incidence and severity of postoperative complications of MNg were significantly higher than those of NNg (P༜0.05). The average hospitalization costs of MNg was higher, the duration of postanesthesia care unit (PACU), duration of antibiotic use was longer and the duration of indwelling drainage tube were longer than NNg (P༜0.05). The volume of indwelling drainage tube were more than NNg (P༜0.05). Conclusion GNRI is an effective and reliable tool to evaluate preoperative nutritional status of prostate cancer, which is closely related to postoperative recovery and complications,and has predictive value.