Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2022; 14(9): 1771-1784
Published online Sep 15, 2022. doi: 10.4251/wjgo.v14.i9.1771
Nomogram for predicting the prognosis of tumor patients with sepsis after gastrointestinal surgery
Ren-Xiong Chen, Zhou-Qiao Wu, Zi-Yu Li, Hong-Zhi Wang, Jia-Fu Ji
Ren-Xiong Chen, Hong-Zhi Wang, ICU, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China
Zhou-Qiao Wu, Zi-Yu Li, Jia-Fu Ji, Department of Gastrointestinal Surgery, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing 100142, China
Author contributions: Chen RX and Wu ZQ contributed equally to this work; Chen RX and Wu ZQ designed the research and wrote the first manuscript; Li ZY contributed conceiving the research and analyzing data; Wang HZ and Ji JF conducted the analysis and provided guidance of the research, and they were co-corresponding authors; all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by Medical Ethical Committee of Peking University Cancer Hospital.
Informed consent statement: All ICU patients or their next of kin were given information that their data was stored in our registry for quality control and research purposes and the option to have their data deleted.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Zhi Wang, MD, Professor, ICU, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100142, China. wanghz58@sina.com
Received: April 6, 2022
Peer-review started: April 6, 2022
First decision: June 12, 2022
Revised: June 19, 2022
Accepted: July 27, 2022
Article in press: July 27, 2022
Published online: September 15, 2022
Processing time: 156 Days and 1.9 Hours
Abstract
BACKGROUND

There were few studies on the prognosis of tumor patients with sepsis after gastrointestinal surgery and there was no relevant nomogram for predicting the prognosis of these patients.

AIM

To establish a nomogram for predicting the prognosis of tumor patients with sepsis after gastrointestinal surgery in the intensive care unit (ICU).

METHODS

A total of 303 septic patients after gastrointestinal tumor surgery admitted to the ICU at Peking University Cancer Hospital from January 1, 2013 to December 31, 2020 were analysed retrospectively. The model for predicting the prognosis of septic patients was established by the R software package.

RESULTS

The most common infection site of sepsis after gastrointestinal surgery in the ICU was abdominal infection. The 90-d all-cause mortality rate was 10.2% in our study group. In multiple analyses, we found that there were statistically significant differences in tumor type, septic shock, the number of lymphocytes after ICU admission, serum creatinine and total operation times among tumor patients with sepsis after gastrointestinal surgery (P < 0.05). These five variables could be used to establish a nomogram for predicting the prognosis of these septic patients. The nomogram was verified, and the initial C-index was 0.861. After 1000 internal validations of the model, the C-index was 0.876, and the discrimination was good. The correction curve indicated that the actual value was in good agreement with the predicted value.

CONCLUSION

The nomogram based on these five factors (tumor type, septic shock, number of lymphocytes, serum creatinine, and total operation times) could accurately predict the prognosis of tumor patients with sepsis after gastrointestinal surgery.

Keywords: Tumor; Surgery; Sepsis; Gastrointestinal; Nomogram

Core Tip: There were few studies on the prognosis of tumor patients with sepsis after gastrointestinal surgery and there was no relevant nomogram for predicting the prognosis of these patients. The aim of the study was to establish a nomogram for predicting the prognosis of tumor patients with sepsis after gastrointestinal surgery in the intensive care unit (ICU).The most common infection site of sepsis was abdominal infection and the 90-d all-cause mortality rate was 10.2% in our study group. In multiple analyses, we found that there were statistically significant differences in tumor type, septic shock, the number of lymphocytes after ICU admission, serum creatinine and total operation times among tumor patients with sepsis after gastrointestinal surgery (P < 0.05). These five variables could be used to establish a nomogram for predicting the prognosis of these septic patients. The nomogram was verified, and the initial C-index was 0.861. After 1000 internal validations of the model, the C-index was 0.876, and the discrimination was good. The correction curve indicated that the actual value was in good agreement with the predicted value.