Nomogram for prediction of prolonged postoperative ileus after colorectal resection

Abstract

Background Prolonged postoperative ileus (PPOI) is a major complication in patients undergoing colorectal resection. The aim of this study was to analyze the risk factors contributing to PPOI, and to develop an effective nomogram to determine the risks of this population. Methods A total of 1,254 patients with colorectal cancer who underwent radical colorectal resection at Fujian Cancer Hospital from March 2016 to August 2021 were enrolled as a training cohort in this study. Univariate analysis and multivariate logistic regressions were performed to determine the correlation between PPOI and clinicopathological characteristics. A nomogram predicting the incidence of PPOI was constructed. The cohort of 153 patients from Fujian Provincial Hospital were enrolled as a validation cohort. Internal and external validations were used to evaluate the prediction ability by area under the receiver operating characteristic curve (AUC) and a calibration plot. Results In the training cohort, 128 patients (10.2%) had PPOI after colorectal resection. The independent predictive factors of PPOI were identified, and included gender, age, surgical approach and intraoperative fluid overload. The AUC of nomogram were 0.779 (95% CI: 0.736–0.822) and 0.791 (95%CI: 0.677–0.905) in the training and validation cohort, respectively. The two cohorts of calibration plots showed a good consistency between nomogram prediction and actual observation. Conclusions A highly accurate nomogram was developed and validated in this study, which can be used to provide individual prediction of PPOI in patients after colorectal resection, and this predictive power can potentially assist surgeons to make the optimal treatment decisions.

Nomogram for predicting prolonged postoperative ileus after laparoscopic low anterior resection for rectal cancer

“…reported an incidence of PPOI of 19.75% in gastrectomy for gastric cancer [5], while Lind et al showed an incidence of 10.2% by analyzing 1254 patients with colorectal cancer [10].…”

“…Consequently, these models make a signi cant contribution to the development of strategies to reduce or prevent the occurrence of PPOI. However, to our knowledge, few studies have used nomogram prediction models to assess the risk of PPOI after colorectal surgery, especially in patients undergoing rectal surgery [5,9,10].…”

Effect of Chewing Gum in reducing Postoperative Ileus after Gastro-duodenal perforation peritonitis surgery: a prospective randomized controlled trial

“…Various risk factors for development of POI have been identi ed including increasing age, hypokalaemia, hypo-proteinemia, renal failure, peritoneal sepsis, American Society of Anesthesiologists scores 3 to 4, open approach, operative di culty, longer operative duration, bowel handling, drop in hematocrit or need for a transfusion, increasing crystalloid administration, intraoperative uid overload and delayed mobilization. [9,11] In its pathological form it can potentially result in increased nausea and vomiting, increased postoperative pain, pulmonary complications, poor wound healing, delayed oral intake, delay in postoperative mobilization, increased length of hospital stays (LOHS), increased resource use and healthcare costs. [9,10,12,13] Hence, it merits attention of researchers.…”

A Novel Nomogram for Identifying the Patients at Risk for Rapid Progression of Advanced Hormone-Sensitive Prostate Cancer

“…Consistently, Gleason sum and HALP were found to be particular risk factors for progression-free survival in metastatic PCa patients who underwent cytoreductive radical prostatectomy by Guo et al 27 The nomogram has been used extensively by oncologists to produce prognostic information for specific patients owing to its intuitive design and statistical probability. 28,29 With the aid of multivariate Cox regression analysis, an unique nomogram was created in this work by combining the severe LUTS, HALP score, and Gleason sum. The combined nomogram worked well as an all-encompassing scoring system for predicting the progression of CRPC, the calibration curve and C-index (0.794, 95% CI: 0.759-0.829 and 0.816, 95% CI: 0.757-0.875 for the training and validation cohorts, respectively) provided support for this prediction.…”