Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients
Abstract Aim The purpose was to explore the independent risk factors for esophagogastric anastomotic leakage (EGAL) and establish a nomogram. Methods Patients who underwent esophagectomy were enrolled and randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The differen...
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BMC
2025-03-01
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| Series: | Perioperative Medicine |
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| Online Access: | https://doi.org/10.1186/s13741-024-00487-4 |
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| author | Jiang-shan Huang Li-tao Yang Jia-fu Zhu Qi-hong Zhong Fei-long Guo Zhen-yang Zhang Jiang-bo Lin |
| author_facet | Jiang-shan Huang Li-tao Yang Jia-fu Zhu Qi-hong Zhong Fei-long Guo Zhen-yang Zhang Jiang-bo Lin |
| author_sort | Jiang-shan Huang |
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| description | Abstract Aim The purpose was to explore the independent risk factors for esophagogastric anastomotic leakage (EGAL) and establish a nomogram. Methods Patients who underwent esophagectomy were enrolled and randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The differences between the two groups of factors were analyzed by difference analysis, and multivariate regression analysis was subsequently performed. A nomogram was established, and the feasibility of the nomogram was verified by analyzing the discrimination, calibration, and decision curves. Results A total of 775 patients were enrolled, including 532 in the training cohort and 223 in the validation cohort. Multivariate regression analysis revealed that age, smoking history, drinking history, nutritional indicators, and anastomotic location were independent risk factors. In terms of discrimination, in the training group, the area under the curve was 0.757 (P = 0.025). In the calibration curve, the curves and fitting lines before and after correction in the training group and the validation group were basically the same. The results of the Hosmer–Lemeshow test showed that the chi-square value of the training cohort was 5.48 (P = 0.791). In the decision curve analysis of the training set, when the threshold probability was in the range of 5–63%, the net benefit of patients was greater than that of the two extreme curves. Conclusion Preoperative malnutrition is an independent risk factor for EGAL. A diagnostic model, developed on age, anastomotic location, smoking status, and drinking history, was a reliable noninvasive tool to timely predict the occurrence of AL. |
| format | Article |
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| institution | OA Journals |
| issn | 2047-0525 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
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| series | Perioperative Medicine |
| spelling | doaj-art-11b9f55c9942472cae95c85c53e343ee2025-08-20T02:10:21ZengBMCPerioperative Medicine2047-05252025-03-0114111210.1186/s13741-024-00487-4Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patientsJiang-shan Huang0Li-tao Yang1Jia-fu Zhu2Qi-hong Zhong3Fei-long Guo4Zhen-yang Zhang5Jiang-bo Lin6Department of Thoracic Surgery, Fujian Medical University Union HospitalDepartment of Thoracic Surgery, Baoji Traditional Chinese Medicine HospitalDepartment of Thoracic Surgery, Fujian Medical University Union HospitalDepartment of Thoracic Surgery, Fujian Medical University Union HospitalDepartment of Thoracic Surgery, Fujian Medical University Union HospitalDepartment of Thoracic Surgery, Fujian Medical University Union HospitalDepartment of Thoracic Surgery, Fujian Medical University Union HospitalAbstract Aim The purpose was to explore the independent risk factors for esophagogastric anastomotic leakage (EGAL) and establish a nomogram. Methods Patients who underwent esophagectomy were enrolled and randomly divided into a training cohort and a validation cohort at a ratio of 7:3. The differences between the two groups of factors were analyzed by difference analysis, and multivariate regression analysis was subsequently performed. A nomogram was established, and the feasibility of the nomogram was verified by analyzing the discrimination, calibration, and decision curves. Results A total of 775 patients were enrolled, including 532 in the training cohort and 223 in the validation cohort. Multivariate regression analysis revealed that age, smoking history, drinking history, nutritional indicators, and anastomotic location were independent risk factors. In terms of discrimination, in the training group, the area under the curve was 0.757 (P = 0.025). In the calibration curve, the curves and fitting lines before and after correction in the training group and the validation group were basically the same. The results of the Hosmer–Lemeshow test showed that the chi-square value of the training cohort was 5.48 (P = 0.791). In the decision curve analysis of the training set, when the threshold probability was in the range of 5–63%, the net benefit of patients was greater than that of the two extreme curves. Conclusion Preoperative malnutrition is an independent risk factor for EGAL. A diagnostic model, developed on age, anastomotic location, smoking status, and drinking history, was a reliable noninvasive tool to timely predict the occurrence of AL.https://doi.org/10.1186/s13741-024-00487-4Anastomotic leakageNomogramNutritional status |
| spellingShingle | Jiang-shan Huang Li-tao Yang Jia-fu Zhu Qi-hong Zhong Fei-long Guo Zhen-yang Zhang Jiang-bo Lin Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients Perioperative Medicine Anastomotic leakage Nomogram Nutritional status |
| title | Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients |
| title_full | Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients |
| title_fullStr | Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients |
| title_full_unstemmed | Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients |
| title_short | Prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors: a retrospective study of 775 patients |
| title_sort | prediction of esophagogastric anastomotic leakage by nomogram combined with preoperative nutritional status and clinical factors a retrospective study of 775 patients |
| topic | Anastomotic leakage Nomogram Nutritional status |
| url | https://doi.org/10.1186/s13741-024-00487-4 |
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