To establishment a risk prediction model for delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery and verify its application effect.

A total of 257 elderly patients with colorectal cancer admitted to Baoji Central Hospital from March 2021 to March 2024 were enrolled retrospectively, all of whom were treated with laparoscopic radical surgery. They were included in the training group (n=180) and the verification group (n=77) according to a ratio of 7∶3. The recovery from general anesthesia of patients were evaluated, and the clinical data of patients with delayed and normal recovery from general anesthesia in the training group (n=180) were compared. Multivariate Logistic regression analysis was used to summarize the risk factors for delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery. Univariate and multivariate screening were performed to identify key predictors, and the risk factors were incorporated into the Nomogram prediction model to establish a risk prediction model. The predictive accuracy of the model was measured using receiver operating characteristic (ROC) curve, and the calibration of the model was verified using Bootstarp and Clinical decision curve analysis.

Among 257 patients, 105 had delayed recovery after operation, with an incidence of 40.87%. In the training group, those who experienced delayed recovery after surgery were classified as the delayed recovery group (n=72), and the other 108 cases were in the normal recovery group. There were statistically significant differences between the delayed recovery group and the normal recovery group in American Society of Anesthesiologists (ASA) classification, preoperative respiratory dysfunction, anesthesia time, propofol dosage, sufentanil dosage, intraoperative infusion volume, intraoperative hypothermia and postoperative hypokalemia (P<0.05). Logistic multivariate analysis showed that ASA classification, preoperative respiratory dysfunction, anesthesia time, propofol dosage, sufentanil dosage, intraoperative infusion volume, intraoperative hypothermia, and postoperative hypokalemia were all independent risk factors for delayed recovery from general anesthesia after laparoscopic radical surgery in elderly patients with colorectal cancer (P<0.05). The area under the curve of the Nomogram model was 0.860 in the training group and 0.823 in the verification group, the sensitivity and specificity applied to the verification group were 82.53% and 83.46%, respectively.

The risk of delayed recovery from general anesthesia after laparoscopic radical surgery in elderly patients with colorectal cancer is higher, and it is related to ASA classification, preoperative respiratory dysfunction, anesthesia time, propofol dosage, sufentanil dosage, intraoperative infusion volume, intraoperative hypothermia, postoperative hypokalemia and other factors. The prediction model based on the above factors can provide a reliable reference for the risk assessment of delayed recovery from general anesthesia in elderly patients with colorectal cancer after laparoscopic radical surgery.