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Objective To investigate the independent risk factors of comprehensive complication index (CCI) ≥26.2 after radical resection of colon cancer, and use these factors to establish and verify a dynamic web-based nomogram model. Methods The clinical data of colon cancer patients who underwent radical resection in the Affiliated Hospital of Jiangnan University from November 2020 to April 2022 were retrospectively collected, and divided into main cohort (November 2020 to October 2021, n=438) and validation cohort (November 2021 to April 2022, n=196). CCI scores of all patients were obtained based on CCI calculator (http://www.assessurgery.com). Univariate and multivariate logistic regression analysis were performed to identify the risk factors for CCI ≥26.2, and a nomogram model was constructed. Receiver operator characteristic curve (ROC), C index and calibration curve were used to evaluate the differentiation and consistency of predictive nomogram model, and the decision curve analysis was conducted to assess the clinical benefits of the model. Internal validation of the model is performed in the validation cohort. Results A total of 438 patients were identified in present study, of which 63 cases (14.4%) had CCI ≥26.2. Multivariate logistic regression analysis revealed that age ≥60 years (OR=2.662, 95%CI 1.341-5.285, P=0.005), low third lumbar spine skeletal muscle mass index (L3MI; OR=4.572, 95%CI 2.435-8.583, P<0.001), NRS2002 ≥3 (OR=4.281, 95%CI 2.304-7.952, P<0.001), and preoperative bowel obstruction (OR=3.785, 95%CI 1.971-7.268, P<0.001) were significant independent risk factors for postoperative CCI ≥26.2. Based on these results, a static and web-based dynamic nomogram was established (https://jndxfsyywcwksyf.shinyapps.io/DynNomCCI/). The C-index and area under the curve (AUC) of the nomogram were 0.742 and 0.787, respectively. The calibration curve indicated a good consistency between the predicted probability and the actual probability. In the validation cohort, the nomogram also presented good discrimination (C-index=0.722, AUC=0.795) and predictive consistency. The decision curve analysis indicated the clinical benefit and application value of the nomogram prediction model. Conclusion This easy-to-use dynamic nomogram based on 4 independent risk factors can conveniently and reliably predict the probability of CCI ≥26.2 after radical resection of colon cancer, which helps optimize the preoperative evaluation system, formulate precise individualized treatment strategies, and enhance recovery after surgery.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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