A novel model based on clinical and computed tomography (CT) indices to predict the risk factors of postoperative major complications in patients undergoing pancreaticoduodenectomy.

IF 2.3 3区生物学 Q2 MULTIDISCIPLINARY SCIENCES

PeerJ Pub Date : 2024-12-19 eCollection Date: 2024-01-01 DOI:10.7717/peerj.18753

Jiaqi Wang, Kangjing Xu, Changsheng Zhou, Xinbo Wang, Junbo Zuo, Chenghao Zeng, Pinwen Zhou, Xuejin Gao, Li Zhang, Xinying Wang

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引用次数: 0

Abstract

Background: Postoperative complications are prone to occur in patients after radical pancreaticoduodenectomy (PD). This study aimed to construct and validate a model for predicting postoperative major complications in patients after PD.

Methods: The clinical data of 360 patients who underwent PD were retrospectively collected from two centers between January 2019 and December 2023. Visceral adipose volume (VAV) and subcutaneous adipose volume (SAV) were measured using three-dimensional (3D) computed tomography (CT) reconstruction. According to the Clavien-Dindo classification system, the postoperative complications were graded. Subsequently, a predictive model was constructed based on the results of least absolute shrinkage and selection operator (LASSO) multivariate logistic regression analysis and stepwise (stepAIC) selection. The nomogram was internally validated by the training and test cohort. The discriminatory ability and clinical utility of the nomogram were evaluated by area under the receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA).

Results: The major complications occurred in 13.3% (n = 48) of patients after PD. The nomogram revealed that high VAV/SAV, high system inflammation response index (SIRI), high triglyceride glucose-body mass index (TyG-BMI), low prognostic nutritional index (PNI) and CA199 ≥ 37 were independent risk factors for major complications. The C-index of this model was 0.854 (95%CI [0.800-0.907]), showing excellent discrimination. The calibration curve demonstrated satisfactory concordance between nomogram predictions and actual observations. The DCA curve indicated the substantial clinical utility of the nomogram.

Conclusion: The model based on clinical and CT indices demonstrates good predictive performance and clinical benefit for major complications in patients undergoing PD.

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来源期刊

PeerJ MULTIDISCIPLINARY SCIENCES-

CiteScore

4.70

自引率

3.70%

发文量

1665

审稿时长

10 weeks

期刊介绍： PeerJ is an open access peer-reviewed scientific journal covering research in the biological and medical sciences. At PeerJ, authors take out a lifetime publication plan (for as little as $99) which allows them to publish articles in the journal for free, forever. PeerJ has 5 Nobel Prize Winners on the Board; they have won several industry and media awards; and they are widely recognized as being one of the most interesting recent developments in academic publishing.