Development and validation of nomogram estimating post-surgery hospital stay of lung cancer patients: relevance for predictive, preventive, and personalized healthcare strategies

Hu, Xiaoxin; Xu, Songtao; Wang, Xiaocen; Luo, Jin; Hou, Dongni; Zhang, Xiaomin; Bao, Chen; Yang, Dong; Song, Yuanlin; Bai, Chunxue

doi:10.1007/s13167-019-00168-z

Cited by 8 publications

(11 citation statements)

References 39 publications

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“…The anchor (PPCs) we used significantly correlated with postoperative length of stay, which is commonly used in oncology practice for reflecting surgical skill and quality of care. 55 Development of any PPCs, even if mild, is associated with reduced survival, prolonged stay in the hospital and increased in-hospital mortality. 56 Additionally, our analysis demonstrated that the CP6-defined severe SOB level was associated with higher MDASI-LC symptom interference levels, suggesting that CP6 can be interpreted for functional impairment, similar as the pain and fatigue cutpoints anchored on the MDASI symptom interference.…”

Section: Discussionmentioning

confidence: 99%

Shortness of Breath on Day 1 After Surgery Alerting the Presence of Early Respiratory Complications After Surgery in Lung Cancer Patients

Yu¹,

Yu²,

Xu³

et al. 2022

PPA

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Patient-reported outcome (PRO)-based symptom assessment with a threshold can facilitate the early alert of adverse events. The purpose of this study was to determine whether shortness of breath (SOB) on postoperative day 1 (POD1) can inform postoperative pulmonary complications (PPCs) for patients after lung cancer (LC) surgery. Methods: Data were extracted from a prospective cohort study of patients with LC surgery. Symptoms were assessed by the MD Anderson Symptom Inventory-lung cancer module (MDASI-LC) before and daily after surgery. Types and grades of complications during hospitalization were recorded. SOB and other symptoms were tested for a possible association with PPCs by logistic regression models. Optimal cutpoints of SOB were derived, using the presence of PPCs as an anchor. Results: Among 401 patients with complete POD1 MDASI-LC and records on postoperative complications, 46 (11.5%) patients reported Clavien-Dindo grade II-IV PPCs. Logistic regression revealed that higher SOB score on POD1 (odds ratio [OR]=1.13, 95% CI=1.01-1.27), male (OR=2.86, 95% CI=1.32-6.23), open surgery (OR=3.03, 95% CI=1.49-6.14), and lower forced expiratory volume in one second (OR=1.78, 95% CI=1.66-2.96) were significantly associated with PPCs. The optimal cutpoint was 6 (on a 0-10 scale) for SOB. Patients reporting SOB < 6 on POD1 had shorter postoperative length of stay than those reporting 6 or greater SOB (median, 6 vs 7, P =0.007). Conclusion: SOB on POD1 can inform the onset of PPCs in patients after lung cancer surgery. PRO-based symptom assessment with a clinically meaningful threshold could alert clinicians for the early management of PPCs.

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Section: Discussionmentioning

confidence: 99%

Shortness of Breath on Day 1 After Surgery Alerting the Presence of Early Respiratory Complications After Surgery in Lung Cancer Patients

Yu¹,

Yu²,

Xu³

et al. 2022

PPA

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“…The innovative PPPM is emerging as the hotspot of efforts in healthcare aimed at curbing the prevalence of chronic diseases such as cardiovascular diseases, diabetes and cancer [ 28 , 51 , 52 ]. PPPM concepts have actually been practically applied to cardiovascular diseases, diabetes, oral medicine, chronic diseases, as well as tumor therapy and tumor postoperative evaluation [ 2 , 53 – 55 ]. But the study of SHS and PS related factors among nurses in English literature was not searched.…”

Section: Discussionmentioning

confidence: 99%

Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status

et al. 2020

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Background Suboptimal health status (SHS) is a reversible state between ideal health and illness and it can be effectively reversed by risk prediction, disease prevention, and personalized medicine under the global background of predictive, preventive, and personalized medicine (PPPM) concepts. More and more Chinese nurses have been troubled by psychological symptoms (PS). The correlation between PS and SHS is unclear in nurses. The purpose of current study is to investigate the prevalence of SHS and PS in Chinese nurses and the relationship between SHS and PS along with predisposing factors as well as to discuss the feasibility of improving health status and preventing diseases according to PPPM concepts in Chinese nurses. Methods A cross-sectional study was conducted with the cluster sampling method among 9793 registered nurses in Foshan city, China. SHS was evaluated with the Suboptimal Health Status Questionnaire-25 (SHSQ-25). Meanwhile, the PS of depression and anxiety were evaluated with Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS) self-assessment questionnaires. The relationship between PS and SHS in Chinese nurses was subsequently analyzed. Results Among the 9793 participants, 6107 nurses were included in the final analysis. The prevalence of SHS in the participants was 74.21% (4532/6107) while the symptoms of depression and anxiety were 47.62% (2908/6107) and 24.59% (1502/6107) respectively. The prevalence of SHS in the participants with depression and anxiety was significantly higher than those without the symptoms of depression (83.3% vs 16.7%, P < 0.001) and anxiety (94.2% vs 5.8%, P < 0.0001). The ratio of exercise habit was significantly lower than that of non-exercise habit (68.8% vs 78.4%, P < 0.001) in SHS group. Conclusions There is a high prevalence of SHS and PS in Chinese nurses. PS in Chinese nurses are associated with SHS. Physical exercise is a protective factor for SHS and PS so that the exercise should be strongly recommended as a valuable preventive measure well in the agreement with PPPM philosophy. Along with SDS and SAS, SHSQ-25 should also be highly recommended and applied as a novel predictive/preventive tool for the health measures from the perspectives of PPPM in view of susceptible population and individual screening, the predisposition to chronic disease preventing, personalization of intervention, and the ideal health state restoring.

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“…LOS was calculated from the date of admission to the date of checkout. A LOS exceeding the third quartile value of the study population was defined as prolonged LOS [17][18][19][20][21][22]. Specifically, hospitalization < 13 days was defined as normal LOS; whereas, hospitalization ≥ 14 days was defined as prolonged LOS.…”

Section: Definitionmentioning

confidence: 99%

A novel model for predicting prolonged stay of patients with type-2 diabetes mellitus: a 13-year (2010–2022) multicenter retrospective case–control study

Tan

Zhang

et al. 2023

J Transl Med

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Background Length of stay (LOS) is an important metric for evaluating the management of inpatients. This study aimed to explore the factors impacting the LOS of inpatients with type-2 diabetes mellitus (T2DM) and develop a predictive model for the early identification of inpatients with prolonged LOS. Methods A 13-year multicenter retrospective study was conducted on 83,776 patients with T2DM to develop and validate a clinical predictive tool for prolonged LOS. Least absolute shrinkage and selection operator regression model and multivariable logistic regression analysis were adopted to build the risk model for prolonged LOS, and a nomogram was taken to visualize the model. Furthermore, receiver operating characteristic curves, calibration curves, and decision curve analysis and clinical impact curves were used to respectively validate the discrimination, calibration, and clinical applicability of the model. Results The result showed that age, cerebral infarction, antihypertensive drug use, antiplatelet and anticoagulant use, past surgical history, past medical history, smoking, drinking, and neutrophil percentage-to-albumin ratio were closely related to the prolonged LOS. Area under the curve values of the nomogram in the training, internal validation, external validation set 1, and external validation set 2 were 0.803 (95% CI [confidence interval] 0.799–0.808), 0.794 (95% CI 0.788–0.800), 0.754 (95% CI 0.739–0.770), and 0.743 (95% CI 0.722–0.763), respectively. The calibration curves indicated that the nomogram had a strong calibration. Besides, decision curve analysis, and clinical impact curves exhibited that the nomogram had favorable clinical practical value. Besides, an online interface (https://cytjt007.shinyapps.io/prolonged_los/) was developed to provide convenient access for users. Conclusion In sum, the proposed model could predict the possible prolonged LOS of inpatients with T2DM and help the clinicians to improve efficiency in bed management.

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Development and validation of nomogram estimating post-surgery hospital stay of lung cancer patients: relevance for predictive, preventive, and personalized healthcare strategies

Cited by 8 publications

References 39 publications

Shortness of Breath on Day 1 After Surgery Alerting the Presence of Early Respiratory Complications After Surgery in Lung Cancer Patients

Shortness of Breath on Day 1 After Surgery Alerting the Presence of Early Respiratory Complications After Surgery in Lung Cancer Patients

Psychological symptoms in Chinese nurses may be associated with predisposition to chronic disease: a cross-sectional study of suboptimal health status

A novel model for predicting prolonged stay of patients with type-2 diabetes mellitus: a 13-year (2010–2022) multicenter retrospective case–control study

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