The Establishment And Analysis Of Prediction Model Of Severe Complications After Abdominal Surgery

ObjectiveTo analyze the preoperative nutrition and inflammation status and the occurrence of serious postoperative complications in patients with abdominal surgery.To investigate the correlation between preoperative nutrition and inflammation status and severe postoperative complications in patients undergoing abdominal surgery,screen for meaningful indicators to predict the occurrence of postoperative severe complications,construct a prediction model for postoperative severe complications,then evaluate The predictive value of postoperative complications to guides the prevention of severe postoperative complications.MethodRetrospective analyse the clinical data of patients who were admitted to the General Surgery of Tianjin Medical University General hospital from July 2017 to September 2019 and underwent abdominal surgery.A total of 223 patients were included according to certain inclusion and exclusion criteria.According to the Clavien classification system,patients with grade III and above complications were divided into the study group,and the remaining patients were the control group.To compare nutrition and inflammation-related indicators such as height,weight,albumin,prealbumin,lymphocyte count,and neutrophil count before surgery between the two groups.Analysis of the correlation between preoperative nutrition and inflammation status and the occurrence of serious complications after operation.Logistic regression analysis was used to construct a predictive model of severe complications.The ROC curve of combined diagnosis was used to analyze its predictive value for severe postoperative complications.ResultAccording to the Clavien classification system,53 of the 223 patients undergoing abdominal surgery in the study had grade III or higher complications.The complication rate was 23.7%,of which 7 patients died and the mortality rate was 3.1%.Ninety patients(40.4%)had nutritional risk before surgery.Comparing patients with different clinical outcomes,we found that the elderly,preoperative low prealbumin,albumin,transferrin and hemoglobin content,lymphocyte counts,and high neutrophil counts often indicate a poor prognosis and are more prone to postoperative complications(P <0.05).There were no significant differences in height,weight,BMI,creatinine,and platelet content(P> 0.05).A predictive model for severe complications after abdominal surgery was established.PCP = 11.633-0.199 × albumin count-0.013 × prealbumin count.Based on whether or not postoperative complications occurred,the area under the curve of the receiver operating characteristic curve of the NRS2002 score,NLR score,and PCP score were 0.654,0.732,and 0.863,respectively.The predictive value of the PCP score for postoperative complications was higher than NRS2002 score and NLR score.ConclusionThe incidence of preoperative nutritional risk is higher in patients undergoing abdominal surgery.Preoperative nutritional risk and inflammatory status are risk factors for postoperative complications.Although the NRS2002 score,NLR score,and PCP score can predict the occurrence of severe postoperative complications,compared with the NRS2002 score and NLR score,the PCP score can comprehensively and objectively predict the occurrence of severe postoperative complications in patients undergoing abdominal surgery.It can help clinicians identify people at high risk of serious complications after surgery,then actively improve related indicators before surgery,and reduce the incidence of complications after surgery.