A nomogram model to predict postoperative delirium in esophageal cancer patients undergoing esophagectomy.

IF 3.4 2区医学 Q2 ONCOLOGY

BMC Cancer Pub Date : 2025-07-01 DOI:10.1186/s12885-025-14478-1

Chen Chen, Jiayu Wang, Yang Li

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引用次数: 0

Abstract

Background: Postoperative delirium (POD) after esophagectomy is one of the most serious complications for cases with esophageal cancer (EC). This study determined to obtain predictive factors for POD and develop a nomogram model to predict the occurrence of POD among EC patients.

Methods: LASSO and multivariate logistic regression analyses were utilized to identify potential predictive factors. A nomogram model was developed based on the results of multivariate logistic regression analysis.

Results: Totally, 924 EC patients undergoing esophagectomy were included, and 157 (16.99%) patients developed POD. Results of LASSO and multivariate logistic analyses showed that age > 70 years, use of penehyclidine hydrochloride, open surgery, preoperative lymphocyte ≤ 1.45*10⁹/L, preoperative albumin ≤ 43.6 g/L, preoperative prognostic nutritional index (PNI) ≤ 50.9, preoperative neutrophil-to-lymphocyte ratio (NLR) > 2.33, preoperative platelet-to-white cell ratio (PWR) ≤ 34.97, and postoperative PNI ≤ 39.40 were independent risk factors for POD. This nomogram model showed a good predictive ability with a C-index value of 0.832 (95% CI: 0.797-0.867). The calibration curve suggested that the predicted results of this nomogram model were in concordance with the actual results. The decision curve analysis (DCA) of this nomogram indicated that there were net benefits for predicting POD.

Conclusion: This nomogram model helps clinicians to predict the occurrence of POD in patients with EC.

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预测食管癌术后谵妄的nomogram模型。

背景：食管切除术后谵妄（POD）是食管癌（EC）最严重的并发症之一。本研究旨在获得POD的预测因素，建立预测EC患者POD发生的nomogram模型。方法：采用LASSO和多因素logistic回归分析，找出可能的预测因素。在多元logistic回归分析的基础上，建立了nomogram模型。结果：共纳入924例食管切除术EC患者，157例（16.99%）发生POD。LASSO及多因素logistic分析结果显示，年龄> ~ 70岁、使用盐酸苯乙利醚、开放性手术、术前淋巴细胞≤1.45*109/L、术前白蛋白≤43.6 g/L、术前预后营养指数(PNI)≤50.9、术前中性粒细胞与淋巴细胞比值(NLR) > 2.33、术前血小板与白细胞比值(PWR)≤34.97、术后PNI≤39.40是发生POD的独立危险因素。该模态图模型具有较好的预测能力，c -指数值为0.832 （95% CI: 0.797-0.867）。标定曲线表明，该模型的预测结果与实际结果基本一致。决策曲线分析（DCA）表明，预测POD有净收益。结论：该nomogram模型有助于临床医生预测EC患者POD的发生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Cancer 医学-肿瘤学

CiteScore

6.00

自引率

2.60%

发文量

1204

审稿时长

6.8 months

期刊介绍： BMC Cancer is an open access, peer-reviewed journal that considers articles on all aspects of cancer research, including the pathophysiology, prevention, diagnosis and treatment of cancers. The journal welcomes submissions concerning molecular and cellular biology, genetics, epidemiology, and clinical trials.