Abstract
Objective: To develop and validate a nomogram model for predicting postoperative pulmonary complications (PPCs) in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery.Methods: We used the least absolute shrinkage and selection operator (LASSO) regression model to analyze the independent risk factors for PPCs in patients with diffuse peritonitis who underwent emergency gastrointestinal surgery. Using R, we developed and validated a nomogram model for predicting PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery.Results: The LASSO regression analysis showed that AGE, American Society of Anesthesiologists physical status classification (ASA), DIAGNOSIS, platelets (on the 3rd day after surgery), cholesterol (on the 3rd day after surgery), ALBUMIN (on the first day after surgery), and preoperative ALBUMIN were independent risk factors for PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery. The area under the curve (AUC) value of the nomogram model in the training group was 0.8240; its accuracy was 0.7000, and its sensitivity was 0.8658. This demonstrates that the nomogram has a high prediction value. Also in the test group, the AUC value of the model established by the variables AGE, ASA, and platelets (on the 3rd day after surgery), cholesterol (on the 3rd day after surgery), ALBUMIN (on the first day after surgery), and preoperative ALBUMIN was 0.8240; its accuracy was 0.8000; and its specificity was 0.8986. In the validation group, the same results were obtained. The results of the clinical decision curve show that the benefit rate was also high.Conclusion: Based on the risk factors AGE, ASA, DIAGNOSIS, platelets (on the 3rd day after surgery), cholesterol (on the 3rd day after surgery), ALBUMIN (on the first day after surgery), and preoperative ALBUMIN, the nomogram model established in this study for predicting PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery has high accuracy and discrimination.
Highlights
Complicated intra-abdominal infections extend beyond organs and may result in localized or diffused peritonitis [1]
We based nomogram establishment and evaluation on the independent prognostic factors shown in the logistic regression analysis, and we used R to establish a nomogram prognostic model for pulmonary complications (PPCs) in patients undergoing emergency gastrointestinal surgery (Figure 2)
We found that AGE, American Society of Anesthesiologists physical status classification (ASA), DIAGNOSIS, PLATELET.3, CHOLESTEROL.3, ALBUMIN.1, and ALBUMIN.0 were independent risk factors for PPCs in patients with diffuse peritonitis
Summary
Complicated intra-abdominal infections extend beyond organs and may result in localized or diffused peritonitis [1]. Postoperative pulmonary complications (PPCs), an important cause of morbidity after upper abdominal surgery, resulting in a significant increase in hospital stays and medical costs [3]. It is of great significance to the prevention and treatment of PPCs to explore risk factors for PPCs after upper abdominal surgery and to screen high-risk patients. These are both hot topics in clinical research. By analyzing the clinical data of patients with diffuse peritonitis undergoing emergency gastrointestinal surgery, this study explores these patients’ independent risk factors for PPCs. The aim was to develop and validate individualized prediction of PPCs in patients with diffuse peritonitis undergoing emergency gastrointestinal surgery, assist in the clinical identification of high-risk patients, and provide scientific guidance for the individualized prevention and treatment of PPCs
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