Analysis of Risk Factors of Acute Respiratory Failure After Radical Resection for Esophageal Cancer and Construction of a Nomogram Prediction Model
[Objective]To analyze the risk factors of acute respiratory failure(ARF)after radical resection for esophageal cancer and to develop a nomogram prediction model.[Methods]Clinical data of 146 patients who underwent radical resection for esophageal cancer in First Affiliated Hospital of Hebei North University from December 2018 to December 2022 were retrospectively analyzed,among whom ARF developed after surgery in 49 patients(ARF group)and ARF did not occur in 97 patients(non-ARF group).The risk factors of ARF after radical resection were analyzed by Logistic regression.The receiver operating characteristic(ROC)curves was used to evaluate the efficiency of each risk factor in predicting ARF after radical resection.R language software 4.0"rms"package was used to construct a nomogram model for predicting ARF after radical resec-tion.The calibration curve and decision curve were used to internally validate the nomogram model and evaluate its predictive performance.[Results]There were significant differences in age,serum albumin level,surgery duration,smoking history,lung surgery history,anastomotic fistula and pleural adhesion between the two groups(all P＜0.05).The area under the ROC curve(AUC)of age,serum albumin level and surgery duration were 0.761,0.692 and 0.712,respectively.Age(＞54.00 years old),serum albumin level(＜38.15 g/L),surgery duration(＞3.08 h),smoking history(yes),lung surgery history(yes),anastomotic fistula(yes)and pleural adhesion(yes)were independent risk factors for ARF after radical resection for esophageal cancer.C-index of the nomogram model for predicting the occurrence of ARF after radical resection was 0.725(95％CI:0.640～0.772),with a threshold＞0.21.The calibration curve showed good consistency between observed values and predicted values.The nomogram model provided clinical net benefits that were higher than each independent predictive factor alone.[Conclusion]The nomogram model developed in this study has good predictive performance and clini-cal application value,which can provide a certain reference for the prevention of ARF after radical resection for esophageal cancer.
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