原发性结直肠恶性肿瘤根治术后结局的危险因素及预测模型构建

Objective To analyze the risk factors of poor outcomes after radical resection of primary colorectal cancer, and to construct and validate a risk prediction model. Methods A total of 118 patients who underwent radical resection of colorectal cancer in Suining County People's Hospital from January 2022 to December 2024 were retrospectively enrolled. According to whether there were events such as delayed recovery within 30 days after surgery, they were divided into good outcome group(82 cases) and poor outcome group(36 cases). Collected clinical and pathological data as well as laboratory parameters from patients. Univariate and multivariate Logistic regression analyses were used to screen independent influencing factors and construct a prediction model. Hosmer-Lemeshow test and ROC curve were used to evaluate the calibration and discrimination of the model. Results Multivariate analysis showed that hypertension, operation time and tumor located in the rectum were independent risk factors for poor postoperative outcomes, and prognostic nutritional index(PNI) was a protective factor. The AUC of the prediction model based on the above factors was 0.851 in the training set and 0.829 in the validation set. The model fitted well and had good predictive ability. Conclusion Hypertension, prolonged operation time, rectal tumor and low PNI are the key predictors of poor outcomes after radical resection of colorectal cancer. The prediction model based on these factors has good discrimination efficiency, which can provide reference for clinical preoperative risk assessment and individualized intervention.