JOURNAL OF CLINICAL SURGERY ›› 2020, Vol. 28 ›› Issue (7): 654-657.doi: 10.3969/j.issn.1005-6483.2020.07.016

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Establishment and preliminary validation of a predictive scoring system for risk of PPOI after radical gastrectomy for gastric cancer

  

  1. Department of the First Hepatobiliary Surgery,Affiliated Hospital of North Sichuan Medical College,Sichuan,Nanchong 637000,China
  • Online:2020-07-20 Published:2020-07-20

Abstract: Objective To construct a simple scoring system for predicting the risk of PPOI,and to preliminarily validate its predictive effectiveness.
Methods A total of 296 patients with gastric cancer were collected.Patients were divided into PPOI group and non PPOI group and the possible risk factors were analyzed.According to the weight of related risk factors,a risk scoring system was constructed and verified.
Results Of the 296 patients,92 cases developed PPOI,the incidence was 31.1%.Multivariable analysis showed that age more than 65 years old,operation duration more than 4h,operation mode of laparotomy,TNM staging=Ⅲ and TOP>0.3mg/Kg were independent risk factors of PPOI(P<0.05).Assigning values with regression coefficients=1.5 and 2.5,each risk factor was assigned 1.5 points,1.0 points,1.5 points,1.5 points and 2.5 points,respectively.The total score of the scoring system was 8.According to different scores,they were divided into low risk group(0~3 points),medium risk group(4~6 points)and high risk group(7~8 points).Taking the patient data into the established scoring system,the incidence of PPOI in the low,middle and high risk group were 10.4%,26.8% and 72.5%,respectively.The area under the ROC curve is 0.731,the sensitivity and specificity were 0.74 and 0.62,χ2=1.526,P=0.93.The model has good fitting validity and high prediction value.
Conclusion A variety of risk factors are involved in the occurrence of PPOI.The prediction model has a good evaluation efficiency and has certain clinical application value.

Key words: delayed intestinal paralysis, gastric neoplasms, risk factors, receiver operating curve

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