Construction and validation of a risk-prediction model for anastomotic leakage after radical gastrectomy: A cohort study in China

作     者：Jinrui Wang Xiaolin Liu Hongying Pan Yihong Xu Mizhi Wu Xiuping Li Yang Gao Meijuan Wang Mengya Yan Jinrui Wang;Xiaolin Liu;Hongying Pan;Yihong Xu;Mizhi Wu;Xiuping Li;Yang Gao;Meijuan Wang;Mengya Yan

作者机构：Nursing DepartmentSir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China Department of General SurgerySir Run Run Shaw HospitalZhejiang University School of MedicineHangzhou 310016China School of NursingZhejiang Chinese Medical UniversityHangzhou 310053China 

出 版 物：《Laparoscopic, Endoscopic and Robotic Surgery》 (腔镜、内镜与机器人外科（英文）)

年 卷 期：2024年第7卷第1期

页      面：34-43页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：This workwas supported by the Medical and Health Science and Technology Project of Zhejiang Province(No.2021KY180) 

主　　题：Stomach neoplasms Anastomotic leak Risk factors Prediction model Risk assessment 

摘      要：Objectives:Anastomotic leakage(AL)stands out as a prevalent and severe complication following gastric cancer *** frequently precipitates additional serious complications,significantly influencing the overall survival time of *** study aims to enhance the risk-assessment strategy for AL following gastrectomy for gastric ***:This study included a derivation cohort and validation *** derivation cohort included patients who underwent radical gastrectomy at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine,from January 1,2015 to December 31,*** evidence-based predictor questionnaire was crafted through extensive literature review and panel *** on the questionnaire,inpatient data were collected to form a model-derivation *** cohort underwent both univariate and multivariate analyses to identify factors associated with AL events,and a logistic regression model with stepwise regression was developed.A 5-fold cross-validation ensured model *** validation cohort included patients from August 1,2021 to December 31,2021 at the same *** the same imputation method,we organized the validation-queue *** then employed the risk-prediction model constructed in the earlier phase of the study to predict the risk of AL in the subjects included in the validation *** compared the predictions with the actual occurrence,and evaluated the external validation performance of the model using model-evaluation indicators such as the area under the receiver operating characteristic curve(AUROC),Brier score,and calibration ***:The derivation cohort included 1377 patients,and the validation cohort included 131 *** independent predictors of AL after radical gastrectomy included age
65 y,preoperative albumin35 g/L,resection extent,operative time
240 min,and intraoperative blood loss
90 *** predictive model exhibited a solid AUROC of 0.750(95%CI:0.694e0.806;p0.001)with a Br