[Nomogram prediction model of cervical anastomotic leakage after esophageal cancer surgery].

医学 列线图 食管癌 外科 吻合 胸腔积液 宫颈癌 泄漏 内科学 癌症 环境工程 工程类
作者
S R,Feng Han,Gefei Zhao,Hua Bai,Lin Zhao,Zuohui Zhao
出处
期刊:PubMed 卷期号:45 (12): 1065-1076
标识
DOI:10.3760/cma.j.cn112152-20201127-01026
摘要

Objective: To retrospectively analyze the risk factors of anastomotic leakage in the neck after esophageal cancer and establish a nomogram prediction model that can accurately predict the occurrence of anastomotic leakage in the neck of the patient. Methods: The study retrospectively analyzed 702 patients who underwent radical esophageal cancer surgery between January 2010 and May 2015 at Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. A multivariate logistic regression model was used to determine the risk factors for neck anastomotic leak, and a nomogram model was constructed, internal validation methods were used to evaluate and verify the predictive effectiveness of the nomogram. Results: There were 702 patients in the whole group, 492 in the training group and 210 in the validation group. The incidence of postoperative cervical anastomotic leak was 16.1% (79/492) in 492 patients with esophageal cancer in the training group. Multifactorial analysis revealed calcification of the descending aorta (OR=2.12, 95% CI: 1.14, 3.94, P=0.018), calcification of the celiac artery (OR=2.29, 95% CI: 1.13, 4.64, P=0.022), peripheral vascular disease (OR=5.50, 95% CI: 1.64, 18.40, P=0.006), postoperative ventilator-assisted breathing (OR=5.33, 95% CI: 1.83, 15.56, P=0.002), pleural effusion or septic chest (OR=3.08, 95% CI: 1.11, 8.55, P=0.031), incisional fat liquefaction and infection (OR=3.49, 95% CI: 1.68, 7.27, P=0.001) were independent risk factors for the development of cervical anastomotic leak after esophageal cancer surgery. The results of the nomogram prediction model showed that the consistency indices of the training and external validation groups were 0.73 and 0.74, respectively (P<0.001), suggesting that the prediction model has good predictive efficacy. Conclusion: The nomogram prediction model can intuitively predict the incidence of postoperative cervical anastomotic leakage in patients with high prediction accuracy, which can help provide a clinical basis for preventing cervical anastomotic leak and individualized treatment of patients.目的: 回顾性分析食管癌术后颈部吻合口漏的危险因素,建立预测食管癌术后患者颈部吻合口漏发生的列线图预测模型。 方法: 回顾性分析2010年1月至2015年5月期间在中国医学科学院肿瘤医院行食管癌根治术患者(702例)的临床病理资料,颈部吻合口漏的危险因素分析采用logistic回归模型,依据影响因素构建列线图。采用内部验证法评价验证列线图的预测效能。 结果: 全组702例患者,训练组492例,验证组210例。492例患者中,食管癌术后颈部吻合口漏发生率为16.1%(79/492)。多因素分析显示,降主动脉钙化(OR=2.12,95% CI:1.14~3.94,P=0.018)、腹腔动脉钙化(OR=2.29,95% CI:1.13~4.64,P=0.022)、外周血管病(OR=5.50,95%CI:1.64~18.40,P=0.006)、术后呼吸机辅助呼吸(OR=5.33,95%CI:1.83~15.56,P=0.002)、胸腔积液或脓胸(OR=3.08,95%CI:1.11~8.55,P=0.031)、切口脂肪液化及感染(OR=3.49,95%CI:1.68~7.27,P=0.001)为食管癌术后发生颈部吻合口漏的独立危险因素。依据食管癌术后吻合口漏的独立危险因素建立的列线图预测模型显示,内部训练组和外部验证组一致性指数分别为0.73和0.74(P<0.001),提示预测模型具有较好的预测效能。 结论: 列线图预测模型可以直观的预测患者术后颈部吻合口漏的发生率,且预测准确度较高,有助于为患者颈部吻合口漏的预防和患者的个体化治疗提供临床依据。.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
完美惜寒发布了新的文献求助10
1秒前
le123zxc完成签到,获得积分10
1秒前
1秒前
SYLH应助檀熹采纳,获得10
3秒前
3秒前
3秒前
知性的囧发布了新的文献求助10
4秒前
4秒前
dypdyp应助lifesci_ming采纳,获得30
4秒前
4秒前
5秒前
完美的友蕊应助le123zxc采纳,获得10
5秒前
娃娃菜妮发布了新的文献求助10
6秒前
小智发布了新的文献求助10
7秒前
vv完成签到,获得积分10
7秒前
RONG完成签到,获得积分10
7秒前
apeng完成签到,获得积分10
7秒前
001完成签到,获得积分10
7秒前
7秒前
西北大灰狼完成签到,获得积分10
8秒前
洪七公完成签到,获得积分10
8秒前
共享精神应助缓慢笑柳采纳,获得10
8秒前
张佳明发布了新的文献求助10
9秒前
冷静数据线完成签到,获得积分10
9秒前
9秒前
molotov完成签到,获得积分20
10秒前
英俊的铭应助夜盏丿采纳,获得10
10秒前
11秒前
Luu发布了新的文献求助30
11秒前
wanci应助娃娃菜妮采纳,获得10
12秒前
汉堡包应助风趣安青采纳,获得10
13秒前
13秒前
pluvia完成签到,获得积分10
14秒前
guozi完成签到,获得积分10
14秒前
晨心完成签到,获得积分10
14秒前
14秒前
斯文败类应助超靓诺言采纳,获得10
15秒前
15秒前
molotov发布了新的文献求助10
15秒前
15秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Cognitive Neuroscience: The Biology of the Mind 1000
Technical Brochure TB 814: LPIT applications in HV gas insulated switchgear 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Picture Books with Same-sex Parented Families: Unintentional Censorship 500
不知道标题是什么 500
A Preliminary Study on Correlation Between Independent Components of Facial Thermal Images and Subjective Assessment of Chronic Stress 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3969398
求助须知:如何正确求助?哪些是违规求助? 3514239
关于积分的说明 11173064
捐赠科研通 3249531
什么是DOI,文献DOI怎么找? 1794934
邀请新用户注册赠送积分活动 875501
科研通“疑难数据库(出版商)”最低求助积分说明 804827