Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer

[Objectives] To analyze the influencing factors for postoperative intestinal obstruction of colorectal cancer and construct a prediction model. [Methods] A retrospective analysis was conducted on 300 patients with colorectal cancer admitted to our hospital from March 2020 to March 2023. They were di...

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Main Authors: Wang Zhen, Chen Linyun, Wang Lin, He Hongqin, Mou Kaidong, Liu Feng
Format: Article
Language:zho
Published: Editorial Office of Journal of Colorectal & Anal Surgery 2024-02-01
Series:结直肠肛门外科
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Online Access:https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=160&cateName=2024%E5%B9%B4%20%E7%AC%AC30%E5%8D%B7%20%E7%AC%AC1%E6%9C%9F
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author Wang Zhen
Chen Linyun
Wang Lin
He Hongqin
Mou Kaidong
Liu Feng
author_facet Wang Zhen
Chen Linyun
Wang Lin
He Hongqin
Mou Kaidong
Liu Feng
author_sort Wang Zhen
collection DOAJ
description [Objectives] To analyze the influencing factors for postoperative intestinal obstruction of colorectal cancer and construct a prediction model. [Methods] A retrospective analysis was conducted on 300 patients with colorectal cancer admitted to our hospital from March 2020 to March 2023. They were divided into an observation group (with intestinal obstruction, n=28) and a control group (without intestinal obstruction, n=272) based on whether intestinal obstruction occurred after surgery. General information, perioperative related indicators, and levels of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL6) before surgery, on the day of surgery, the 3rd day and the 5th day after surgery were compared between the two groups. LASSO regression analysis was used to screen variables for intestinal obstruction after colorectal cancer surgery, and multivariate Logistic regression analysis was used to investigate the independent risk factors for intestinal obstruction after colorectal cancer surgery. A nomogram prediction model for intestinal obstruction after colorectal cancer surgery was constructed. The receiver operating characteristic curve (ROC) and calibration curve were drawn to evaluate the prediction ability and goodness of fit of the model. [Results] The proportions of patients with tumor location in the rectum, tumor stage Ⅲ, preoperative intestinal obstruction, laparotomy and conversion laparotomy, as well as tumor diameter, were higher in the observation group than in the control group (P<0.05). The levels of CRP, PCT, and IL6 on the day of surgery, the 3rd day and the 5th day after surgery were higher in the observation group than in the control group (P<0.05), and the measurement time had no effect on the levels of postoperative CRP, PCT, and IL6 (P>0.05). LASSO regression analysis showed that tumor stage, preoperative intestinal obstruction, surgery type, and levels of CRP, PCT, and IL6 on the 5th day after surgery were variables for intestinal obstruction after colorectal cancer surgery. Multivariate Logistic regression analysis showed that tumor stage Ⅲ, preoperative intestinal obstruction, laparotomy and conversion laparotomy, and levels of CRP, PCT, and IL6 on the 5th day after surgery were independent risk factors for intestinal obstruction after colorectal cancer surgery (P<0.05). The C-index of the nomogram prediction model was 0.865, the area under the ROC curve (AUC) was 0.865 (95%CI: 0.799-0.902), and the C-index of the calibration curve was 0.814, indicating good consistency between the model and the actual observations. [Conclusion] Tumor stage Ⅲ, preoperative intestinal obstruction, laparotomy and conversion laparotomy, and levels of CRP, PCT, and IL6 on the 5th day after surgery are independent risk factors for intestinal obstruction after colorectal cancer surgery. The nomogram model constructed based on these factors has good predictive ability and can provide an important reference for clinically predicting intestinal obstruction after colorectal cancer surgery.
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spelling doaj-art-ba522c2dbe824a9b926b366e9324c8432025-08-20T03:49:17ZzhoEditorial Office of Journal of Colorectal & Anal Surgery结直肠肛门外科1674-04912024-02-01301647110.19668/j.cnki.issn1674-0491.2024.01.011Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancerWang Zhen0Chen Linyun1Wang Lin2He Hongqin3Mou Kaidong4Liu Feng5Endoscopic Diagnosis and Treatment Center, Cangzhou People's Hospital, Cangzhou 061000, Hebei, ChinaDepartment of Neurology, Cangzhou People's Hospital, Cangzhou 061000, Hebei, ChinaMedical Clinical Laboratory Center, Cangzhou People's Hospital, Cangzhou 061000, Hebei, ChinaDepartment of Anorectal Surgery, Cangzhou People's Hospital, Cangzhou 061000, Hebei, ChinaDepartment of Anorectal Surgery, Cangzhou People's Hospital, Cangzhou 061000, Hebei, ChinaDepartment of Anorectal Surgery, Cangzhou People's Hospital, Cangzhou 061000, Hebei, China[Objectives] To analyze the influencing factors for postoperative intestinal obstruction of colorectal cancer and construct a prediction model. [Methods] A retrospective analysis was conducted on 300 patients with colorectal cancer admitted to our hospital from March 2020 to March 2023. They were divided into an observation group (with intestinal obstruction, n=28) and a control group (without intestinal obstruction, n=272) based on whether intestinal obstruction occurred after surgery. General information, perioperative related indicators, and levels of C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL6) before surgery, on the day of surgery, the 3rd day and the 5th day after surgery were compared between the two groups. LASSO regression analysis was used to screen variables for intestinal obstruction after colorectal cancer surgery, and multivariate Logistic regression analysis was used to investigate the independent risk factors for intestinal obstruction after colorectal cancer surgery. A nomogram prediction model for intestinal obstruction after colorectal cancer surgery was constructed. The receiver operating characteristic curve (ROC) and calibration curve were drawn to evaluate the prediction ability and goodness of fit of the model. [Results] The proportions of patients with tumor location in the rectum, tumor stage Ⅲ, preoperative intestinal obstruction, laparotomy and conversion laparotomy, as well as tumor diameter, were higher in the observation group than in the control group (P<0.05). The levels of CRP, PCT, and IL6 on the day of surgery, the 3rd day and the 5th day after surgery were higher in the observation group than in the control group (P<0.05), and the measurement time had no effect on the levels of postoperative CRP, PCT, and IL6 (P>0.05). LASSO regression analysis showed that tumor stage, preoperative intestinal obstruction, surgery type, and levels of CRP, PCT, and IL6 on the 5th day after surgery were variables for intestinal obstruction after colorectal cancer surgery. Multivariate Logistic regression analysis showed that tumor stage Ⅲ, preoperative intestinal obstruction, laparotomy and conversion laparotomy, and levels of CRP, PCT, and IL6 on the 5th day after surgery were independent risk factors for intestinal obstruction after colorectal cancer surgery (P<0.05). The C-index of the nomogram prediction model was 0.865, the area under the ROC curve (AUC) was 0.865 (95%CI: 0.799-0.902), and the C-index of the calibration curve was 0.814, indicating good consistency between the model and the actual observations. [Conclusion] Tumor stage Ⅲ, preoperative intestinal obstruction, laparotomy and conversion laparotomy, and levels of CRP, PCT, and IL6 on the 5th day after surgery are independent risk factors for intestinal obstruction after colorectal cancer surgery. The nomogram model constructed based on these factors has good predictive ability and can provide an important reference for clinically predicting intestinal obstruction after colorectal cancer surgery.https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=160&cateName=2024%E5%B9%B4%20%E7%AC%AC30%E5%8D%B7%20%E7%AC%AC1%E6%9C%9Fcolorectal cancerintestinal obstructioninfluencing factorsprediction model
spellingShingle Wang Zhen
Chen Linyun
Wang Lin
He Hongqin
Mou Kaidong
Liu Feng
Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
结直肠肛门外科
colorectal cancer
intestinal obstruction
influencing factors
prediction model
title Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
title_full Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
title_fullStr Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
title_full_unstemmed Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
title_short Analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
title_sort analysis of influencing factors and construct a prediction model for postoperative intestinal obstruction of colorectal cancer
topic colorectal cancer
intestinal obstruction
influencing factors
prediction model
url https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=160&cateName=2024%E5%B9%B4%20%E7%AC%AC30%E5%8D%B7%20%E7%AC%AC1%E6%9C%9F
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