Analysis Of Risk Factors For Patients With Pulmonary Infection After Radical Resection Of Esophageal Cancer And Establishment Of Nomogram Prediction Risk Model

BackgroundEsophageal cancer is a malignant tumor of the digestive tract that seriously harms human health.At present,the combined treatment of surgery,supplemented by radiotherapy and chemotherapy before and after surgery,is the first choice for clinical surgeons in the treatment of esophageal cancer,because surgery causes great trauma to the body and the incidence of postoperative complications is high.Pulmonary infection is ranking first of the complication of esophagectomy.With the continuous development of anesthesia,perioperative management and surgical techniques,the incidence of postoperative pulmonary infection in patients with esophageal cancer has decreased,but it is still a complication that cannot be ignored during perioperative period.Pulmonary infection is one of the main causes of perioperative death in patients with esophagectomy,which directly affects the prognosis of patients.ObjectiveTo investigate the risk factors of pulmonary infection in patients after radical resection of esophageal cancer,and to establish a risk prediction model based on the nomogram,so as to provide reference for clinical intervention measures.MethodsThe clinical data of 644 patients with esophageal cancer who underwent surgery in the Department of Thoracic Surgery of the First Affiliated Hospital of Xinxiang Medical University from September 2014 to May 2019 were retrospectively analyzed.The risk factors of pulmonary infection were analyzed by multivariate Logistic analysis,and the risk prediction model of the nomogram was established.The accuracy of the model was evaluated by C-index and calibration curve,and predictive validation was performed.ResultsThe pulmonary infection rate was 29.19%(188/644)in 644 patients with esophageal cancer after radical resection.The results of general clinical data analysis showed that the pulmonary infection of patients after radical resection of esophageal cancer was related to age,BMI,tumor location,history of related pulmonary diseases(asthma,emphysema,bronchitis),diabetes,history of smoking,operation methods and operation time(P<0.05).There was no correlation with gender,hypertension,history of drinking,FEV1/FVC,preoperative white blood cell number,ASA score,intraoperative blood loss and postoperative nutrition(P>0.05).Multivariate Logistic analysis showed that age,BMI,history of related pulmonary diseases,diabetes,history of smoking,operation time,tumor location and operation methods were risk factors for pulmonary infection after radical resection of esophageal cancer(P<0.05).The nomogram risk prediction model verified by C-index and calibration curve that the predicted value is basically consistent with the observed value(C-index=0.782),and it has good predictive ability.Conclusions1.Age,BMI,history of related pulmonary diseases,diabetes,history of smoking,operation time,tumor location and operation methods are the risk factors for pulmonary infection after radical resection of esophageal cancer.2.The prediction model in this study has good predictive value.