基于腹部解剖特征的列线图对老年结直肠癌患者术后胃肠道并发症的预测价值OA

Objective To investigate the predictive value of abdominal anatomical features for postoperative gastrointestinal complications(POGICs)in elderly patients with colorectal cancer(CRC),and to establish and validate a clinically applicable predictive nomogram model.Methods Clinical data of patients aged≥70 years who underwent radical CRC resection at Subei People′s Hospital Affiliated to Yangzhou University from January 2022 to January 2025 were retrospectively collected.A total of 150 patients who developed POGICs were enrolled into the complication group,and another 150 patients without POGICs during the same period were randomly selected as the control group(non-complication group)using simple random sampling.All 300 patients were randomly divided into the training cohort and the validation cohort at a ratio of 4∶1.Univariate and multivariate Logistic regression analyses were performed in the training cohort to screen independent risk factors for POGICs and construct a predictive model.The efficacy was verified in the validation cohort.The discrimi-nation ability of the model was assessed by the area under the curve(AUC)of the receiver operating characteris-tic(ROC)curve,the calibration degree by calibration curves,and the clinical application value by decision curve analysis(DCA).Results Multivariate Logistic regression analysis showed that subcutaneous fat thick-ness(SFT),rectus abdominis thickness(RAT),neutrophil-monocyte-lymphocyte ratio(NMLR),and prog-nostic nutritional index(PNI)were independent risk factors for POGICs in elderly CRC patients(P<0.05).The nomogram predictive model established based on the above four indicators exhibited favorable discrimina-tion ability(AUC=0.809 and 0.837,respectively),satisfactory calibration(high fitting degree between cali-bration curves and ideal curves),and favorable clinical benefit(DCA curves showed positive net clinical benefit within a wide threshold range)in both the training and validation cohorts.Conclusion SFT and RAT can serve as independent predictors of POGICs in elderly CRC patients.The dynamic nomogram constructed based on SFT,RAT,NMLR and PNI can effectively identify elderly CRC patients at high risk of POGICs,provid-ing a practical tool for medical staff to formulate individualized prevention and intervention strategies.