Published online Mar 21, 2020. doi: 10.3748/wjg.v26.i11.1185
Peer-review started: December 20, 2020
First decision: February 18, 2020
Revised: February 20, 2020
Accepted: February 21, 2020
Article in press: February 21, 2020
Published online: March 21, 2020
Prolonged postoperative ileus (PPOI) is a prolonged state of “pathological” gastrointestinal (GI) tract dysmotility. PPOI is an essential contributor to increased hospitalization costs and prolonged hospitalization.
It is well known that preoperative albumin affects the outcome and mortality of patients undergoing any surgical procedure. We hypothesized that preoperative albumin may be an independent indicator of PPOI.
The present study aimed to investigate the association between preoperative albumin and PPOI to establish a nomogram for clinical risk evaluation.
A total of 311 patients diagnosed with gastric or colorectal cancer were retrospectively included. We performed univariate and multivariable logistic regression analyses to determine the relationship between variables and PPOI, and a nomogram to quantify the presence of PPOI was developed and internally validated.
The overall PPOI rate was 21.54%. Patients in an advanced tumor stage and who were administered postoperative opioid analgesics were more likely to develop PPOI. This study found and further confirmed that preoperative albumin was an independent predictor of PPOI. A nomogram was established to accurately quantitate the probability of PPOI occurrence. This nomogram was confirmed to have a good diagnostic performance and was also internally validated.
Preoperative albumin is an independent predictive factor of PPOI in patients who underwent GI surgery. An easy-to-use nomogram was established to quantify the presence of PPOI, which may serve as an early warning sign of PPOI in clinical practice.
Due to the retrospective nature of this study, caution should be exercised in proposing the nomogram in clinical practice.