Prediction of systemic inflammatory response index for postoperative complications in patients with obstructive colorectal cancer treated with self-expanding metal stent
10.3760/cma.j.cn115396-20250325-00070
- VernacularTitle:全身炎症反应指数对使用自膨式金属支架治疗的梗阻性结直肠癌患者术后并发症的预测作用
- Author:
Wenchang FAN
1
;
Bin CHEN
;
Hengkai CHEN
;
Jinfu ZHUANG
Author Information
1. 福建医科大学附属第一医院结直肠外科，福州 350005
- Keywords:
Colorectal neoplasms;
Intestinal obstruction;
Postoperative complications;
Nomograms;
Systemic inflammation response index
- From:
International Journal of Surgery
2025;52(9):604-610
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the association between preoperative systemic inflammatory response index (SIRI) and postoperative complications in patients with obstructive colorectal cancer (OCCRC) undergoing self-expanding metal stent (SEMS) as a bridge to surgery, and to develop and assess a predictive model for postoperative complication risk based on key clinical factors.Methods:Clinical data of 104 OCCRC patients who underwent radical surgery following SEMS placement at the Department of Colorectal Surgery, the First Affiliated Hospital of Fujian Medical University, from August 2019 to December 2024 were retrospectively analyzed. Logistic regression was used to identify independent predictors of postoperative complications, and a nomogram was constructed to evaluate predictive performance.Results:The optimal SIRI cutoff value was determined by ROC analysis, and patients were classified into low- ( n=51) and high-SIRI ( n=53) groups.Postoperative complications occurred more frequently in the high-SIRI group than in the low-SIRI group (39.62% vs 13.73%, χ2=8.86, P=0.003). Multivariate logistic regression identified age ( OR=1.05, 95% CI: 1.01-1.09, P=0.027), intraoperative blood loss ( OR=4.45, 95% CI: 1.56-12.75, P=0.005), and high SIRI ( OR=3.73, 95% CI: 1.29-10.83, P=0.015) as independent predictors. The nomogram incorporating these variables showed good predictive ability with an AUC of 0.736. Conclusions:Preoperative elevated SIRI is an independent risk factor for postoperative complications in OCCRC patients treated with SEMS as a bridge to surgery. A nomogram combining SIRI, age and intraoperative blood loss provides effective risk stratification.
