Abstract:
Objective To explore the influencing factors of enteral nutrition(EN)intolerance in patients with esophageal cancer after operation and construct a nomogram risk model.
Methods The clinical data of 158 patients with esophageal cancer admitted to Huai′an Second People′s Hospital from September 2020 to October 2022 were selected and divided into tolerance group(116 cases)and intolerance group(42 cases)according to EN tolerance after operation.The patient′s age, sex, hypertension, hyperglycemia, postoperative drug use, whether serum albumin is normal, EN pathway, whether intestinal injury and other data were collected.Logistic regression analysis was used to analyze the factors influencing EN intolerance after esophageal cancer surgery.R3.6.3 software and rms package were used to construct a nomogram model to predict EN intolerance after esophageal cancer surgery.The differentiation and consistency of EN intolerance nomogram model were evaluated by ROC and calibration curve.
Results The proportions of hyperglycemia, postoperative drug use, abnormal serum albumin and intestinal injury in the intolerance group were significantly higher than those in the tolerance group(P<0.05). Multivariate logistic regression analysis showed that hyperglycemia, postoperative drug use, abnormal serum albumin and intestinal injury were independent risk factors for EN intolerance(P<0.05). The nomogram model showed that the presence of hyperglycemia accounted for 87.5 points, the presence of postoperative drug use accounted for 100 points, the presence of abnormal serum albumin accounted for 69.8 points, and the presence of intestinal injury accounted for 80.00 points.H-L fit test showed that, χ2=8.318, P=0.304, the slope of the calibration curve approached 1, the ROC curve was evaluated for model discrimination, the area under the curve was 0.840(95% CI: 0.773-0.893), and the sensitivity and specificity were 80.95% and 76.72%, respectively.
Conclusion Hyperglycemia, postoperative drug use, abnormal serum albumin and intestinal injury are the influencing factors of EN intolerance in patients with esophageal cancer after surgery.The nomogram model constructed by this method has a higher clinical significance in predicting the risk of EN intolerance in patients with esophageal cancer after surgery.
Key words:
Esophageal cancer,
Intestinal nutrition,
Intolerance,
Nomogram model
Songxia Tu, Hongyan Zheng, Shu Zhu, Xiajun Xu. Influencing factors and establishment of nomogram risk model of enteral nutrition intolerance in postoperative patients with esophageal cancer[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(02): 73-77.