Development of a new risk nomogram of perioperative major adverse cardiac events for Chinese patients undergoing colorectal carcinoma surgery

作者：Zhang, Juhong; Xiao, Ying; Yang, Daya; Zhuang, Xiaodong; Wang, Ling; Gao, Xiuren^*; Huang, Zhibin^*

来源：International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery, 2017, 32(8): 1157-1164.

DOI：10.1007/s00384-017-2812-x

• Anesthesiology
• Intensive care medicine
• Cardiology
• Surgery

The purpose of this study is to create a new risk nomogram to predict perioperative major adverse cardiac events in patients undergoing colorectal carcinoma surgery.
A total of 1899 patients who underwent colorectal carcinoma surgery at a tertiary teaching hospital in China between 2007 and 2012 were recruited. Logistic regression analysis was used to define risk factors for major adverse cardiac events. A nomogram-predicting model was built based on the logistic regression model and discrimination was tested by receiver operating characteristic curves.
Fifty-six (2.9%) among 1899 included patients developed at least one cardiac event. Eight risk factors were found in the multivariate logistic regression model, which included age ae<yen>60 years, smoking, a history of chronic kidney disease, coronary artery disease, congestive heart failure, hypertension, preoperative albumin levels ae<currency>35 g/L, blood transfusion ae<yen>500 mL, and intraoperative blood pressure variability. P = 0.708 in the Hosmer-Lemeshow test indicated acceptable calibration power. Based on this multivariate model, we built a risk nomogram model for these cardiac events with an area under the curve (95% confidence interval) of 0.923 (0.889, 0.957), which demonstrated good discrimination of this model. When the probability cutoff was 1.9% (total score of 83), the nomogram model had the best sensitivity and specificity in predicting cardiac events.
A new nomogram model for predicting perioperative major adverse cardiac events in patients who had colorectal carcinoma surgery was established in this study. When the total score is > 83, patients undergoing colorectal carcinoma surgery should be considered at high risk of perioperative major adverse cardiac events.

• 出版日期2017-8
• 单位中山大学