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已发表论文
胃肠穿孔术后延长住院时间预后模型的开发
Authors Yang Y, Wang F, Li Z, Wang Z
Received 9 July 2025
Accepted for publication 20 January 2026
Published 29 January 2026 Volume 2026:19 552633
DOI https://doi.org/10.2147/IJGM.S552633
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Xudong Zhu
Yufeng Yang, Fang Wang, Zeyuan Li, Zhu Wang
Department of Gastrointestinal Surgery, First People’s Hospital of Pingjiang, Yueyang, Hunan Province, People’s Republic of China
Correspondence: Zhu Wang, Department of Gastrointestinal Surgery, First People’s Hospital of Pingjiang, No. 431, North Street, Chengguan Town, Pingjiang County, Yueyang City, Hunan Province, People’s Republic of China, Tel +86 13339878378, Email 13339878378@163.com
Objective: This study aimed to develop and validate a prognostic nomogram integrating clinical and laboratory variables to predict prolonged hospital stay in patients undergoing surgery for gastrointestinal (GI) perforation, facilitating early risk stratification and informed clinical decision-making.
Patients and Methods: A retrospective retrospective single-center study included 164 surgical patients with GI perforation from 2022– 2024. Variables encompassed demographics, perforation characteristics, and preoperative/postoperative laboratory markers. The least absolute shrinkage and selection operator (LASSO) regression identified key predictors, followed by multivariate logistic regression to construct a nomogram. Model performance was evaluated using the receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).
Results: Upper GI perforation (OR=2.93, 95% CI:1.23– 6.98), smaller perforation diameter (OR=0.48, 95% CI:0.28– 0.82), and lower preoperative albumin (OR=1.10 per unit increase, 95% CI:1.03– 1.17) independently predicted prolonged hospitalization. The nomogram demonstrated good discrimination (training AUC=0.75; validation AUC=0.79) and calibration. DCA confirmed clinical utility, with net benefit surpassing “treat all” or “treat none” strategies across risk thresholds.
Conclusion: In summary, we developed and validated a nomogram that effectively identifies patients at high risk for prolonged hospitalization after GI perforation surgery by integrating three routinely available clinical parameters. This tool aids in optimizing resource allocation and personalized perioperative management. Further multicenter validation is warranted to enhance generalizability and incorporate dynamic biomarkers.
Keywords: gastrointestinal perforation, prognostic model, postoperative outcomes, nomogram
Department of Gastrointestinal Surgery, First People’s Hospital of Pingjiang, Yueyang, Hunan Province, People’s Republic of China
Correspondence: Zhu Wang, Department of Gastrointestinal Surgery, First People’s Hospital of Pingjiang, No. 431, North Street, Chengguan Town, Pingjiang County, Yueyang City, Hunan Province, People’s Republic of China, Tel +86 13339878378, Email 13339878378@163.com
Objective: This study aimed to develop and validate a prognostic nomogram integrating clinical and laboratory variables to predict prolonged hospital stay in patients undergoing surgery for gastrointestinal (GI) perforation, facilitating early risk stratification and informed clinical decision-making.
Patients and Methods: A retrospective retrospective single-center study included 164 surgical patients with GI perforation from 2022– 2024. Variables encompassed demographics, perforation characteristics, and preoperative/postoperative laboratory markers. The least absolute shrinkage and selection operator (LASSO) regression identified key predictors, followed by multivariate logistic regression to construct a nomogram. Model performance was evaluated using the receiver operating characteristic (ROC) curves, calibration plots, and decision curve analysis (DCA).
Results: Upper GI perforation (OR=2.93, 95% CI:1.23– 6.98), smaller perforation diameter (OR=0.48, 95% CI:0.28– 0.82), and lower preoperative albumin (OR=1.10 per unit increase, 95% CI:1.03– 1.17) independently predicted prolonged hospitalization. The nomogram demonstrated good discrimination (training AUC=0.75; validation AUC=0.79) and calibration. DCA confirmed clinical utility, with net benefit surpassing “treat all” or “treat none” strategies across risk thresholds.
Conclusion: In summary, we developed and validated a nomogram that effectively identifies patients at high risk for prolonged hospitalization after GI perforation surgery by integrating three routinely available clinical parameters. This tool aids in optimizing resource allocation and personalized perioperative management. Further multicenter validation is warranted to enhance generalizability and incorporate dynamic biomarkers.
Keywords: gastrointestinal perforation, prognostic model, postoperative outcomes, nomogram