摘要
Abstract
Objective To explore the risk factors of early enteral nutrition feeding intolerance in elderly patients with gastric cancer after operation,and to construct and verify the prediction model.Methods A total of 380 elderly patients with gastric cancer who underwent surgical treatment in the hospital from September 2019 to June 2024 were retrospectively selected and divided into the training set(285 cases)and the validation set(95 cases)at a ratio of 3∶1.According to the tolerance of early postoperative enteral nutrition feeding,the elderly gastric cancer patients in the training set were divided into the control group(194 cases)and the obser-vation group(91 cases).logistic regression model was used to screen independent risk factors,and a nomogram prediction model was constructed and verified.Results Age greater than or equal to 75 years old,start time of enteral nutrition 24 hours after surgery,NRS2002 score greater than or equal to 3 points,use of analgesics and sedatives,addition of dietary fiber,use of nutrient pumps,and elevated fasting blood glucose levels were inde-pendent risk factors for early postoperative enteral nutrition feeding intolerance in elderly gastric cancer pa-tients(P<0.05).In nomogram model,an increase of 2 mmol/L in fasting blood glucose was 8.67 points,age greater than or equal to 75 years old was 15.01 points,enteral nutrition starting 24 hours after surgery was 23.16 points,NRS2002 score greater than or equal to 3 points was 19.04 points,use of analgesics and seda-tives was 22.87 points,no dietary fiber added was 28.64 points,and no nutrition pump used was 22.94 points.The internal and external validation results showed that the H-L goodness of fit test showed that the model fitted well;the calibration curve was basically coincident with the ideal curve,and the model accuracy was good;the model discrimination was good.When the high risk threshold range of the nomogram model was 0.03-0.85(training set)and 0.23-0.73(validation set),the net benefit was positive,and the nomogram model had high clinical practicability.Conclusion The prediction model based on age,starting time of enteral nutrition,NRS2002 score,use of analgesic and sedative drugs,dietary fiber,use of nutrition pump and fasting blood glucose level has high accuracy and discrimination,which has an important guiding role in individualized predic-tion of the risk of early enteral nutrition intolerance in elderly patients with gastric cancer after operation.关键词
胃癌/老年/早期肠内营养/营养喂养不耐受/影响因素/列线图模型Key words
Gastric cancer/Elderly/Early enteral nutrition/Feeding intolerance/Influencing factors/Nomogram model分类
医药卫生
