A Nomogram Predictive Model Of Ileus After Radical Cystectomy

Abstract BACKGROUND: The golden standard for the treatment of muscle-invasive or high-grade bladder cancer is radical cystectomy combined with various forms of urinary diversion, but postoperative paralytic ileus is an troublesome postoperative complication.The purpose of this research is to build and verify the nomogram prediction model of postoperative ileus.METHODS: From January 2015 to December 2020, the clinical data of patients who underwent radical cystectomy in the urology department of Guizhou Provincial People's Hospital for bladder cancer were collected. The risk factors related to postoperative ileus were obtained by logitic single factor and multiple factor regression analysis. Then, the prediction model of postoperative ileus was constructed based on the risk factors and its identification ability and accuracy were verified.RESULT: 252 patients were included, 51 of whom had ileus. Statistical analysis showed that preoperative creatinine level, postoperative creatinine level, and postoperative serum albumin concentration were correlated with postoperative ileus. The area under ROC curve of nomogram predictive model constructed based on the risk factors was 0.748 (95%CI 0.672-0.824). The bootstrap correction curve of the prediction model shows that the prediction accuracy of the model is close to that of the ideal model.CONCLUSION: Preoperative creatinine level, postoperative creatinine level, and postoperative serum albumin concentration were correlated with postoperative ileus and were risk factors for ileus after radical cystectomy, which could be used as predictors of clinical prediction models. The prediction model of nomogram based on these predictors can predict the probability of postoperative intestinal obstruction.