Establishment of a nomogram prognostic model for risk factors of comprehensive complication index after radical gastrectomy for gastric cancer / 中华临床营养杂志

ABSTRACT

Objective:To explore the independent risk factors of comprehensive complication index (CCI) ≥ 26.2 after radical gastrectomy for gastric cancer and to establish and verify a nomogram model.Methods:Clinical data of patients undergoing radical gastrectomy for gastric cancer in Jinling Hospital from September 2017 to March 2019 were retrospectively collected. CCI score of each patient was obtained using CCI calculator. Potential risk factors of CCI ≥ 26.2 were screened by multivariate logistic regression analysis and a nomogram model was established. Besides, the nomogram model was evaluated for differentiation, consistency and clinical usefulness using area under the curve, calibration curves and decision curve, respectively.Results:A total of 237 patients undergoing radical gastrectomy were included, of whom 38 (16.0%) had a CCI ≥ 26.2. Multivariate logistic regression analysis showed that the third lumbar skeletal muscle mass index ( OR = 3.98, P = 0.001), the third lumbar fat mass index ( OR = 3.38, P = 0.002) and age ≥ 65 years( OR = 2.50, P = 0.018) were independent risk factors for postoperative CCI ≥ 26.2. The established nomogram model showed good differentiation, prediction consistency and clinical benefit (AUC = 0.753). Conclusion:The nomogram model based on 3 independent risk factors has good predictive performance and clinical benefit for CCI ≥ 26.2 after radical gastrectomy, which can be applied and promoted in clinical practice to a certain extent.