Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram
Background. Postsurgical gastroparesis syndrome (PGS) after subtotal gastrectomy imposes significant social and economic burdens. We aimed to investigate the relationship between preoperative blood glucose level and PGS and develop a nomogram for individualized prediction. Patients and Methods. We r...
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| Language: | English |
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Wiley
2020-01-01
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| Series: | Journal of Diabetes Research |
| Online Access: | http://dx.doi.org/10.1155/2020/7058145 |
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| author | Chenchen Mao Xin Liu Yunshi Huang Mingming Shi Weiyang Meng Libin Xu Weisheng Chen Yuanbo Hu Xinxin Yang Xiaodong Chen Xian Shen |
| author_facet | Chenchen Mao Xin Liu Yunshi Huang Mingming Shi Weiyang Meng Libin Xu Weisheng Chen Yuanbo Hu Xinxin Yang Xiaodong Chen Xian Shen |
| author_sort | Chenchen Mao |
| collection | DOAJ |
| description | Background. Postsurgical gastroparesis syndrome (PGS) after subtotal gastrectomy imposes significant social and economic burdens. We aimed to investigate the relationship between preoperative blood glucose level and PGS and develop a nomogram for individualized prediction. Patients and Methods. We retrospectively analyzed 633 patients with gastric cancer who underwent subtotal gastrectomy. Preoperative blood glucose levels were evaluated via receiver operating characteristic (ROC) curve analysis. Chi-squared tests and multivariable logistic regression analyses were used to develop a predictive model for PGS, presented as a nomogram, which was assessed for its clinical usefulness. Results. Thirty-eight of 633 patients were diagnosed with PGS. Based on the ROC curve analysis, the preoperative blood glucose cutoff value for PGS was 6.25 mmol/L. The predictors of PGS included preoperative hyperglycemia (odds ratio (OR) 2.3, P=0.03), body mass index (BMI; OR 0.21, P=0.14 for BMI<18.5 and OR 3.0, P=0.004 for BMI>24), and the anastomotic method (OR 7.3, P=0.001 for Billroth II and OR 5.9, P=0.15 for Roux-en-Y). The predictive model showed good discrimination ability, with a C-index of 0.710, and was clinically useful. Conclusions. Preoperative hyperglycemia effectively predicts PGS. We present a nomogram incorporating the preoperative blood glucose level, BMI, anastomotic method, and tumor size, for individualized prediction of PGS. |
| format | Article |
| id | doaj-art-16056618db6d44c58d44e16bd95c3906 |
| institution | Kabale University |
| issn | 2314-6745 2314-6753 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Research |
| spelling | doaj-art-16056618db6d44c58d44e16bd95c39062025-02-03T06:46:51ZengWileyJournal of Diabetes Research2314-67452314-67532020-01-01202010.1155/2020/70581457058145Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable NomogramChenchen Mao0Xin Liu1Yunshi Huang2Mingming Shi3Weiyang Meng4Libin Xu5Weisheng Chen6Yuanbo Hu7Xinxin Yang8Xiaodong Chen9Xian Shen10Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Emergency Medical, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaDepartment of Gastrointestinal Surgery, The Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, ChinaBackground. Postsurgical gastroparesis syndrome (PGS) after subtotal gastrectomy imposes significant social and economic burdens. We aimed to investigate the relationship between preoperative blood glucose level and PGS and develop a nomogram for individualized prediction. Patients and Methods. We retrospectively analyzed 633 patients with gastric cancer who underwent subtotal gastrectomy. Preoperative blood glucose levels were evaluated via receiver operating characteristic (ROC) curve analysis. Chi-squared tests and multivariable logistic regression analyses were used to develop a predictive model for PGS, presented as a nomogram, which was assessed for its clinical usefulness. Results. Thirty-eight of 633 patients were diagnosed with PGS. Based on the ROC curve analysis, the preoperative blood glucose cutoff value for PGS was 6.25 mmol/L. The predictors of PGS included preoperative hyperglycemia (odds ratio (OR) 2.3, P=0.03), body mass index (BMI; OR 0.21, P=0.14 for BMI<18.5 and OR 3.0, P=0.004 for BMI>24), and the anastomotic method (OR 7.3, P=0.001 for Billroth II and OR 5.9, P=0.15 for Roux-en-Y). The predictive model showed good discrimination ability, with a C-index of 0.710, and was clinically useful. Conclusions. Preoperative hyperglycemia effectively predicts PGS. We present a nomogram incorporating the preoperative blood glucose level, BMI, anastomotic method, and tumor size, for individualized prediction of PGS.http://dx.doi.org/10.1155/2020/7058145 |
| spellingShingle | Chenchen Mao Xin Liu Yunshi Huang Mingming Shi Weiyang Meng Libin Xu Weisheng Chen Yuanbo Hu Xinxin Yang Xiaodong Chen Xian Shen Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram Journal of Diabetes Research |
| title | Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram |
| title_full | Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram |
| title_fullStr | Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram |
| title_full_unstemmed | Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram |
| title_short | Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram |
| title_sort | preoperative blood glucose level predicts postsurgical gastroparesis syndrome after subtotal gastrectomy development of an individualized usable nomogram |
| url | http://dx.doi.org/10.1155/2020/7058145 |
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