Complications After Gastrointestinal Surgery In Patients With SARS-COV-2 Infection And Construction Of Prediction Model

Objective:By analyzing the short-term prognosis of patients undergoing gastrointestinal surgery during the pandemic of severe acute respiratory syndrome coronavirus2(SARS-COV-2),the risk factors for early complications after gastrointestinal surgery during the pandemic of SARS-COV-2 were explored,and a nomogram model was constructed to help the clinical decision-making of gastrointestinal surgery patients with a history of SARS-COV-2 infection.Methods:From December 13,2022 to February 20,2023,226 patients admitted to our hospital for surgical treatment due to gastrointestinal diseases who met the inclusion criteria were selected and their clinical diagnosis and treatment data were collected.According to whether SARS-COV-2 infection occurs in the perioperative period,it is divided into infected group and non-infected group.There were 59 patients in the infected group and 167 patients in the non-infected group.The occurrence of postoperative complications in the two groups was compared,and the risk factors for postoperative complications were screened by univariate analysis and multivariate logistic regression analysis.The nomogram model and subject operating characteristic(ROC)curve were drawn by R(4.2.3)software,the fitting effect of the model was tested and evaluated by Hosmer-Lemeshow,and the calibration curve was drawn by the Calibrate function in the rms package to test the prediction effect of the model.Result:1.Compared with the non-infected group,the infected group had a longer hospitalization time and higher hospital costs,and there was no significant difference between the two groups in terms of operation duration and postoperative ventilation time.2.The difference between the infected group and the non-infected group in the occurrence of chest complications was not significant difference,and the difference in the occurrence of abdominal complications and other complications was significant difference.3.Univariate analysis showed that age,COPD,diagnosis,surgical category,timing of surgical delay,preoperative hemoglobin,preoperative lymphocyte count,preoperative platelet count and postoperative CRP were related to the occurrence of postoperative complications,and multivariate analysis showed that the timing of surgical delay,preoperative lymphocyte count,and postoperative CRP were independent risk predictors for postoperative complications.4.The nomogram prediction model based on three independent predictors factors,and the model has good discrimination,calibration and goodness-of-fit,reflecting good consistency with the actual results.Conclusion:Perioperative infection with SARS-COV-2 increases the risk of postoperative complications in gastrointestinal surgery,and the nomogram prediction model established by us can better predict the probability of postoperative complications in patients during the SARS-COV-2 epidemic,which can help the clinical decision-making of gastrointestinal surgery patients in the post-SARS-COV-2 era.