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Background <p>Postoperative pulmonary infection (PPI) remains a significant complication in elderly patients with colorectal cancer (CRC). This study aimed to identify risk factors for PPI and develop a predictive model for PPI.</p> Methods <p>A retrospective analysis was conducted on 339 elderly patients with CRC undergoing radical resection. Patients were categorized into PPI and non-PPI groups. Clinical, surgical, and laboratory variables were collected. Univariate and multivariate logistic regression analyses were performed, and independent predictors of PPI were identified. A nomogram was constructed and validated internally by R.</p> Results <p>In a study of 339 patients, 40 individuals developed PPI with an incidence of 11.8%. The study identified five independent risk factors: advanced age (OR = 1.13, 95%CI: 1.03–1.25, <i>P</i> = 0.014), increased mFI positive items (OR = 3.19, 95%CI: 1.70–5.99, <i>P</i> &lt; 0.001), elevated CONUT (OR = 2.23, 95%CI: 1.25–3.98, <i>P</i> = 0.007), decreased GNRI (OR = 0.94, 95%CI: 0.90–0.99, <i>P</i> = 0.010) and PNI scores (OR = 0.88, 95%CI: 0.81–0.97, <i>P</i> = 0.010). The nomogram displayed good discrimination (AUC: 0.82) and calibration. Independent validation from the same institution confirmed excellent performance (AUC: 0.866).</p> Conclusions <p>Age, mFI, and poor nutritional status are independent predictors of PPI in elderly patients with CRC. This nomogram serves as a practical tool for individualized risk assessment and perioperative management.</p>

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A prediction model based on nutritional variables of postoperative pulmonary infection after colorectal cancer surgery

  • 期刊论文

  • 发表日期：

    2025年11月11日

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  • Jing Sun,
  • Jie Chen,
  • Zhenzhen Li

摘要

Background

Postoperative pulmonary infection (PPI) remains a significant complication in elderly patients with colorectal cancer (CRC). This study aimed to identify risk factors for PPI and develop a predictive model for PPI.

Methods

A retrospective analysis was conducted on 339 elderly patients with CRC undergoing radical resection. Patients were categorized into PPI and non-PPI groups. Clinical, surgical, and laboratory variables were collected. Univariate and multivariate logistic regression analyses were performed, and independent predictors of PPI were identified. A nomogram was constructed and validated internally by R.

Results

In a study of 339 patients, 40 individuals developed PPI with an incidence of 11.8%. The study identified five independent risk factors: advanced age (OR = 1.13, 95%CI: 1.03–1.25, P = 0.014), increased mFI positive items (OR = 3.19, 95%CI: 1.70–5.99, P < 0.001), elevated CONUT (OR = 2.23, 95%CI: 1.25–3.98, P = 0.007), decreased GNRI (OR = 0.94, 95%CI: 0.90–0.99, P = 0.010) and PNI scores (OR = 0.88, 95%CI: 0.81–0.97, P = 0.010). The nomogram displayed good discrimination (AUC: 0.82) and calibration. Independent validation from the same institution confirmed excellent performance (AUC: 0.866).

Conclusions

Age, mFI, and poor nutritional status are independent predictors of PPI in elderly patients with CRC. This nomogram serves as a practical tool for individualized risk assessment and perioperative management.