Preoperative prediction model of anastomotic leakage after colorectal surgery

Objective To analyze the preoperative risk factors of anastomotic leakage after colorectal surgery, construct a preoperative prediction model of anastomotic leakage after colorectal surgery, evaluate the probability of anastomotic leakage after surgery, and guide clinical decision-making. Methods From January 1, 2007 to December 31, 2016, 1 340 patients who underwent colorectal surgery and primary anastomosis in the Central Theater Command General Hospital of the Chinese People’s Liberation Army (formerly Wuhan General Hospital of Guangzhou Military Region) were collected. The risk factors of anastomotic leakage were analyzed by R-3.5.2. The forecasting model of contour map was drawn by RMS software package in R software. Results There are 123 cases of anastomotic leakage occurred in this study. The incidence of anastomotic leakage was 9.18% (123/1 340). Preoperative body mass index (BMI) was larger (Z=2.128, P 0.75 indicated that the model had good predictive ability. The AUC for predicting anastomotic leakage after colorectal surgery is 0.86, which has good predictive performance. Conclusion Large BMI, high NRS2002 score, no nutritional support at the lesion site in rectum and before operation are independent risk factors for anastomotic leakage. The constructed contour map prediction model is helpful to predict the probability of anastomotic leakage after operation. Key words: Colorectal; Anastomotic leakage; Risk factors; Prediction model