ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1553163
This article is part of the Research TopicAdvances in Esophageal Cancer: Treatment Updates and Future ChallengesView all 9 articles
A nomogram predicting the risk of postoperative pneumonia after esophagectomy in esophageal carcinoma
Provisionally accepted
- 1Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
- 2Department of Gastrointestinal Surgery, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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Background: Pneumonia is a common complication following esophagectomy, which is related with an increased risk of mortality and hospitalization. This condition not only prolongs hospital stays but also raises healthcare costs. The aim of this study was to identify risk variables and develop a nomogram for predicting postoperative pneumonia (PP).Methods: A total of 647 individuals who had esophageal cancer surgery between January 1, 2010, and December 31, 2020, were involved in this study. We used least absolute shrinkage and selection operator (LASSO) regression for screening the optimal predictive factors and subsequently developed a nomogram using the selected factors. Verification through the use of 500 bootstrap resampling techniques. To assess the nomogram's discriminating power, we used the calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA).Results: According to the standard error criteria of non-zero coefficients of LASSO and multivariate logistic regression analyses, age, smoking, double-lumen endotracheal tube (DLET), combined intravenous and inhalation anesthesia (CIIA), and vasoactive drugs usage are independent risk indicators of PP. Based on these five predictors we created a nomogram. The area under the of nomogram for the ROC curve was 0.665(95% CI: 0.620-0.704) in development and 0.691 (95%CI: 0.654-0.726) in 500 bootstraps resample validation. Additionally, the calibration curves showed a high degree of agreement between the actual and predicted probabilities. DCA displayed that the predictive model had a net benefit when the risk thresholds were 0.17-0.61.This study developed an intuitive nomogram model to predict postoperative pneumonia in esophageal cancer patients based on age, smoking history, DLET, CIIA, and vasoactive medication usage.Proper anesthesia, ETT type, smoking cessation, and timely vasoactive medication use can lower risks.Further external validation and large-scale studies are needed.
Keywords: nomogram, Predict, risk, Pneumonia, Esophagectomy
Received: 30 Dec 2024; Accepted: 28 May 2025.
Copyright: © 2025 Li, Chen and Ke. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Meizhen Li, Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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