Construction of a model predicting the risk of tube feeding intolerance after gastrectomy for gastric cancer based on 225 cases from a single Chinese center

// Wu Xiaoyong 1, 2, * , Li Xuzhao 1, * , Yu Deliang 1, * , Yu Pengfei 1, * , Hang Zhenning 1 , Bai Bin 1 , Li Zhengyan 1 , Pang Fangning 1 , Wang Shiqi 1 and Zhao Qingchuan 1 1 Division of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, 710032, Xi’an, Shaanxi, China 2 Department of Hepatobiliary Surgery, Shanxi Provincial People's Hospital, 030012, Taiyuan, Shanxi, China * These authors contributed equally to this work Correspondence to: Wang Shiqi, email: 15029246125@126.com Zhao Qingchuan, email: zhaoqc@fmmu.edu.cn Keywords: tube feeding intolerance, gastric cancer, gastrectomy, risk facts, predictive model Received: July 07, 2017      Accepted: September 20, 2017      Published: October 23, 2017 ABSTRACT Identifying patients at high risk of tube feeding intolerance (TFI) after gastric cancer surgery may prevent the occurrence of TFI; however, a predictive model is lacking. We therefore analyzed the incidence of TFI and its associated risk factors after gastric cancer surgery in 225 gastric cancer patients divided into without-TFI ( n = 114) and with-TFI ( n = 111) groups. A total of 49.3% of patients experienced TFI after gastric cancer. Multivariate analysis identified a history of functional constipation (FC), a preoperative American Society of Anesthesiologists (ASA) score of III, a high pain score at 6-hour postoperation, and a high white blood cell (WBC) count on the first day after surgery as independent risk factors for TFI. The area under the curve (AUC) was 0.756, with an optimal cut-off value of 0.5410. In order to identify patients at high risk of TFI after gastric cancer surgery, we constructed a predictive nomogram model based on the selected independent risk factors to indicate the probability of developing TFI. Use of our predictive nomogram model in screening, if a probability > 0.5410, indicated a high-risk patients would with a 70.1% likelihood of developing TFI. These high-risk individuals should take measures to prevent TFI before feeding with enteral nutrition.