Nomogram for predicting postoperative ileus after radical cystectomy and urinary diversion: a retrospective single-center study

Abstract

Objective

To predict the incidence of postoperative ileus in bladder cancer patients after radical cystectomy.

Methods

We retrospectively analyzed the perioperative data of 452 bladder cancer patients who underwent radical cystectomy with urinary diversion at the Second Hospital of Tianjin Medical University between 2016 and 2021. Univariate and multivariate logistic regression were used to identify the risk factors for postoperative ileus. Finally, a nomogram model was established and verified based on the independent risk factors.

Results

Our study revealed that 96 patients (21.2%) developed postoperative ileus. Using multivariate logistic regression analysis, we found that the independent risk factors for postoperative ileus after radical cystectomy included age > 65.0 years, high or low body mass index, constipation, hypoalbuminemia, and operative time. We established a nomogram prediction model based on these independent risk factors. Validation by calibration curves, concordance index, and decision curve analysis showed a strong correlation between predicted and actual probabilities of occurrence.

Conclusion

Our nomogram prediction model provides surgeons with a simple tool to predict the incidence of postoperative ileus in bladder cancer patients undergoing radical cystectomy.

Keywords:

• Postoperative ileus
• bladder cancer
• radical cystectomy
• prediction model
• nomogram

Authors’ contributions

XYS and CL retrieved and analyzed all of the data in the study. CWZ and ZHZ revised the manuscript for important intellectual contents. XYS and CL designed, checked and supervise all study process. All authors contributed to the article and approved the submitted version.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The raw data of this study and more information can be found upon reasonable request from the author (SXY).

Additional information

Funding

This research was supported by The National Key Research and Development Program of China (2021YFC2009300, 2021YFC2009303), the Open Fund of State Key Laboratory of Environmental Chemistry and Ecotoxicology (KF2021-20).