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J Gastrointest Surg. 2018 Mar;22(3):421-429. doi: 10.1007/s11605-017-3580-1. Epub 2018 Jan 12.

A Novel Nomogram for Predicting Postsurgical Intra-abdominal Infection in Gastric Cancer Patients: a Prospective Study.

Author information

1
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Shangcai Village, Wenzhou, Zhejiang Province, China.
2
Department of General Surgery, Zhejiang University Huzhou Hospital, Huzhou, Zhejiang, China.
3
Department of Gastroenterology, Jinhua First People's Hospital, Jinhua, Zhejiang, China.
4
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Shangcai Village, Wenzhou, Zhejiang Province, China. 352161451@qq.com.
5
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Shangcai Village, Wenzhou, Zhejiang Province, China. shenxian5166@gmail.com.
6
Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. shenxian5166@gmail.com.

Abstract

BACKGROUND:

This study aimed to determine the relationship between intra-abdominal infection (IAI) and sarcopenia prospectively and to construct a nomogram to identify patients at a high risk of IAI.

METHODS:

We conducted a prospective study of 682 consecutive patients with gastric cancer who underwent radical gastrectomy. The sarcopenia elements, including lumbar skeletal muscle index, handgrip strength, and gait speed, were measured before surgery. Factors contributing to IAI were determined through univariate and multivariate analysis. A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of IAI.

RESULTS:

Of the 682 patients enrolled in this study, 132 patients were diagnosed with sarcopenia and 61 were diagnosed with IAI. Logistic analysis revealed that sarcopenia, tumor size, pathological type, and multivisceral resection were independent prognostic factors for IAI. The nomogram model for IAI was able to reliably quantify the risk of IAI with a strong optimism-adjusted discrimination (concordance index, 0.736).

CONCLUSIONS:

Sarcopenia is an independent predictor of IAI. Our nomogram was a simple and practical instrument to quantify the individual risk of IAI and could be used to identify patients at a high risk.

KEYWORDS:

Intra-abdominal infection; Nomogram; Sarcopenia

PMID:
29330724
DOI:
10.1007/s11605-017-3580-1
[Indexed for MEDLINE]

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