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©The Author(s) 2024.
World J Gastrointest Surg. Mar 27, 2024; 16(3): 717-730
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.717
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.717
Table 1 Demographic and Crohn’s disease data in patients undergoing intestinal resection
Variables | Total (n = 181) | Major postoperative complication1 | P value | |
Yes (10) | No (171) | |||
Sex | 0.281 | |||
Male | 127 (70.2) | 5 (50.0) | 122 (71.3) | |
Female | 54 (29.8) | 5 (50.0) | 49 (28.7) | |
Age at surgery (yr) | 39.04 ± 13.0 | 36.7 ± 15.7 | 39.2 ± 12.8 | 0.558 |
Duration of disease (yr) | 4.9 ± 5.2 | 5.6 ± 4.7 | 4.8 ± 5.2 | 0.454 |
BMI (kg/m2) | 19.2 ± 3.4 | 18.0 ± 3.6 | 19.2 ± 3.4 | 0.137 |
Weight loss > 10% in 6 months prior to surgery | 0.564 | |||
Yes | 66 (36.5) | 5 (50.0) | 61 (35.7) | |
No | 115 (63.5) | 5 (50.0) | 110 (64.3) | |
History of intestinal resection | 0.855 | |||
Yes | 41 (22.7) | 3 (30.0) | 38 (22.2) | |
No | 140 (77.3) | 7 (70.0) | 133 (77.8) | |
Mean preoperative laboratory values | ||||
C reactive protein serum level (mg/L) | 31.2 ± 43.2 | 18.8 ± 12.6 | 31.9 ± 44.3 | 0.901 |
Erythrocyte sedimentation rate (mm/h) | 31.0 ± 15.4 | 38.9 ± 12.3 | 30.6 ± 15.4 | 0.071 |
Platelets (× 109/L) | 295.2 ± 124.2 | 330.4 ± 108.4 | 293.2 ± 125.1 | 0.230 |
Hemoglobin level (g/L) | 115.5 ± 21.3 | 114.8 ± 30.2 | 115.5 ± 20.7 | 0.896 |
Serum albumin (g/L) | 36.3 ± 5.7 | 31.4 ± 5.9 | 36.6 ± 5.6 | 0.005a |
Preoperative therapy (< 3 months before surgery) | 0.075 | |||
No preoperative therapy | 75 (41.4) | 4 (40.0) | 71 (41.5) | |
Steroids2/traditional immunosuppressant3 | 49 (27.1) | 0 (0.0) | 49 (28.7) | |
Biologicals | 45 (24.9) | 5 (50.0) | 40 (23.4) | |
Combo therapy | 12 (6.6) | 1 (10.0) | 11 (6.4) | |
Preoperative CDAI staging | 0.006a | |||
Remission to mild (< 220) | 103 (56.9) | 1 (10.0) | 102 (59.6) | |
Moderate to severe (≥ 220) | 78 (43.1) | 9 (90.0) | 69 (40.4) | |
Age at diagnosis of CD (yr) | 0.601 | |||
A1 (< 17) | 10 (5.5) | 1 (10.0) | 9 (5.3) | |
A2 (17-40) | 122 (67.4) | 7 (70.0) | 115 (67.2) | |
A3 (> 40) | 49 (27.1) | 2 (20.0) | 47 (27.5) | |
Disease location | 0.604 | |||
L1 (ileal) | 35 (19.3) | 1 (10.0) | 34 (19.9) | |
L2 (colonic) | 12 (6.6) | 1 (10.0) | 11 (6.4) | |
L3 (ileocolic) | 134 (74.0) | 8 (80.0) | 126 (73.7) | |
Disease behavior | 0.080 | |||
B2 (stricturing) | 65 (35.9) | 1 (10.0) | 64 (37.4) | |
B3 (penetrating) | 91 (50.3) | 6 (60.0) | 85 (49.7) | |
B2P (structuring with perianal disease) | 7 (3.9) | 0 (0.0) | 7 (4.1) | |
B3P (penetrating with perianal disease) | 18 (9.9) | 3 (30.0) | 15 (8.8) |
Table 2 Surgical data
Variables | Total (n = 181) | Major postoperative complication1 | P value | |
Yes (10) | No (171) | |||
Surgical priority | 0.065 | |||
Selective | 173 (95.6) | 8 (80.0) | 165 (96.5) | |
Emergency | 8 (4.4) | 2 (20.0) | 6 (3.5) | |
Surgical approach | 0.011a | |||
Laparoscopic | 163 (90.1) | 6 (60.0) | 157 (91.8) | |
Open | 6 (3.3) | 1 (10.0) | 5 (2.9) | |
Conversion | 12 (6.6) | 3 (30.0) | 9 (5.3) | |
Type of resection | 0.309 | |||
ICR | 100 (55.2) | 5 (50.0) | 95 (55.6) | |
Right hemicolectomy | 25 (13.8) | 0 (0.0) | 25 (14.6) | |
Left-sided colectomy | 5 (2.8) | 0 (0.0) | 5 (2.9) | |
Subtotal colectomy | 21 (11.6) | 3 (30.0) | 18 (10.5) | |
Segmental resection of small bowel | 30 (16.6) | 2 (20.0) | 28 (16.4) | |
Stoma creation | 0.070 | |||
Yes | 104 (57.5) | 9 (90.0) | 95 (55.6) | |
No | 77 (42.5) | 1 (10.0) | 76 (44.4) | |
Operative time (min) | 147.7 ± 37.6 | 182.0 ± 40.8 | 145.7 ± 36.5 | 0.007a |
Intraoperative blood loss (mL) | 133.1 ± 114.1 | 195.0 ± 138.3 | 129.5 ± 111.9 | 0.048a |
Table 3 Multivariate logistic regression analysis results of factors associated with major postoperative complications (Clavien-Dindo ≥ III)
Variable | Multivariate analysis | ||
OR | 95%CI | P value | |
Preoperative CDAI | |||
Remission to mild (< 220) | Reference | ||
Moderate to severe (≥ 220) | 10.084 | 1.011-100.626 | 0.490 |
Serum albumin (g/L) | 0.826 | 0.705-0.968 | 0.016a |
Surgical approach | |||
Laparoscopic | Reference | ||
Open | 14.161 | 0.830-241.572 | 0.067 |
Conversion | 7.000 | 1.188-41.244 | 0.032a |
Operative time (min) | 1.026 | 1.008-1.045 | 0.005a |
Table 4 Related factors of postoperative hospital stay
Variable | Linear regression analysis | |
Univariate analysis P value | Multivariate analysis P value | |
Sex | 0.798 | |
Age at surgery (yr) | 0.444 | |
Duration of disease (yr) | 0.449 | |
History of intestinal resection | 0.631 | |
BMI (kg/m2) | 0.132 | |
Weight loss > 10% in 6 months prior to surgery | 0.328 | |
Mean preoperative laboratory values | ||
C reactive protein serum level (mg/L) | 0.087 | |
Erythrocyte sedimentation rate (mm/h) | 0.602 | |
Platelets (× 109/L) | 0.886 | |
Hemoglobin level (g/L) | 0.056 | 0.015a |
Serum albumin (g/L) | 0.056 | |
Preoperative CDAI staging | 0.061 | |
Montreal classification | ||
Age at diagnosis of CD (yr) | 0.574 | |
Disease location | 0.342 | |
Disease behavior | 0.947 | |
Surgical priority | < 0.001a | 0.001a |
Surgical approach | < 0.001a | < 0.001a |
Type of resection | 0.039a | |
Stoma creation | 0.504 | |
Operation time (min) | 0.001a | < 0.001a |
Intraoperative blood loss (mL) | 0.004a |
- Citation: Wang FT, Lin Y, Yuan XQ, Gao RY, Wu XC, Xu WW, Wu TQ, Xia K, Jiao YR, Yin L, Chen CQ. Predicting short-term major postoperative complications in intestinal resection for Crohn’s disease: A machine learning-based study. World J Gastrointest Surg 2024; 16(3): 717-730
- URL: https://www.wjgnet.com/1948-9366/full/v16/i3/717.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v16.i3.717