联合肌肉减少症建立模型预测结直肠癌术后腹腔内感染风险

目的：分析直肠癌术后腹腔内感染与肌肉减少症之间的关系，并构建联合模型预测腹腔内感染风险。方法：收集383例接受结直肠癌根治术的患者，在手术前收集并测量诊断肌肉减少症的三要素，包括腰椎骨骼肌指数、术前握力和步行速度。通过单因素和多因素分析确定影响腹腔内感染的因素。构建由独立风险因素组成的联合预测模型，以量化结直肠癌术后腹腔内感染的个体风险。结果：383例患者中，有93例被诊断出肌肉减少症，而44例被诊断出腹腔内感染。Logistic分析表明，肌肉减少症、肿瘤大小、年龄是 结直肠癌术后腹腔内感染的独立预后因素（P ＜0.05）。腹腔内感染的联合预测模型能够可靠地预测及量化结直肠癌术后发生腹腔内感染的风险（一致性指数为0.710）。结论：术前肌肉减少症是结直肠癌术后发生腹腔内感染的的独立预测因子。本联合预测模型是一种简单实用的工具，可量化腹腔内感染的个体风险，用于识别高风险患者。

A model combined with sarcopenia to predict the risk of intra-abdominal infection after colorectal cancer surgery

Objective: To determine the relationship between postoperative intraperitoneal infection and sarcopenia in colorectal cancer and to establish a prediction model with high accuracy to discriminate patients with high risk of intraperitoneal infection. Methods: A prospective study was conducted of 383 colorectal cancer patients undergoing radical resection. The lumbar skeletal muscle index, preoperative grip strength and walking speed were preoperatively measured for sarcopenia diagnosis. Univariate and multivariate analyses were used to identify the potential factors for intraperitoneal infection. A prediction model consisting of independent risk factors was constructed to quantify the individual risk of intraperitoneal infection after colorectal resection. Results: Out of 383 patients, 93 were diagnosed with sarcopenia in the present study, andintraperitoneal infectionoccurred in 44 patients. Multivariate logistic analysis showed that sarcopenia, tumor size and patient’s age were independent factors for intraperitoneal infection predication. The combined prediction model can accurately quantify the individual risk of intraperitoneal infection after colorectal cancer surgery (C-index 0.710). Conclusion: Sarcopenia is an independent risk factor for intraperitoneal infection after colorectal cancer surgery. Our prediction model is a simple and practical tool which can accurately quantify the individual risk of intraperitoneal infection and identify patients with high risk.