Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model

ObjectiveThis study aimed to explore the risk factors of hypokalemia after radical resection of esophageal cancer (EC) and establish a nomogram risk prediction model to evaluate hypokalemia risk after esophagectomy. Thus, this study provides a reference for the clinical development of intervention m...

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Main Authors: Guanqiang Yan, Jingxiao Li, Yiji Su, Guosheng Li, Guiyu Feng, Jun Liu, Xiang Gao, Huafu Zhou
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Surgery
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Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2024.1433751/full
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author Guanqiang Yan
Jingxiao Li
Yiji Su
Guosheng Li
Guiyu Feng
Jun Liu
Xiang Gao
Huafu Zhou
author_facet Guanqiang Yan
Jingxiao Li
Yiji Su
Guosheng Li
Guiyu Feng
Jun Liu
Xiang Gao
Huafu Zhou
author_sort Guanqiang Yan
collection DOAJ
description ObjectiveThis study aimed to explore the risk factors of hypokalemia after radical resection of esophageal cancer (EC) and establish a nomogram risk prediction model to evaluate hypokalemia risk after esophagectomy. Thus, this study provides a reference for the clinical development of intervention measures.MethodsClinical data of EC patients who underwent radical surgery from January 2020 to November 2022 in the First Affiliated Hospital of Guangxi Medical University were retrospectively collected. The relevant variables were screened using multivariate logistic regression analysis with IBM SPSS 25.0 and R 4.2.0 software, and a nomogram for predicting hypokalemia risk was established. The established nomogram was evaluated by receiver operating characteristic (ROC), calibration, and decision curves. The model was also internally validated by 1000 bootstrap resampling methods.ResultsAfter radical EC resection, the incidence rate of hypokalemia in 213 patients was 19.2% (41/213). The hemoglobin levels, total serum protein, serum albumin, calcium ion concentration, direct bilirubin, prothrombin time (PT), and activated partial thromboplastin time (APTT) were related (p < 0.05). The multivariate logistic analysis showed that the white blood cell count, serum albumin level, direct bilirubin, and operation time were risk factors for hypokalemia after radical EC resection (p < 0.05). The area under the ROC curve (AUC) was 0.764, demonstrating the good discriminative ability of the established nomogram for hypokalemia prediction. The calibration curve showed a good fit between the predicted and actual observed probabilities. The model maintained a high C-index in the internal validation (C-index = 0.758), supporting that the nomogram can be widely used for hypokalemia prediction.ConclusionThe prediction model for hypokalemia risk with individualized scores based on the patient's white blood cell count, serum albumin level, direct bilirubin, and operation time can screen out high-risk patients who might develop hypokalemia. It is of certain reference value for clinicians to screen and follow up with patients with emphasis and to formulate preoperative and postoperative intervention strategies.
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spelling doaj-art-3f5a97b48a1f4258aef5f5bd60e027992025-01-07T06:41:29ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011110.3389/fsurg.2024.14337511433751Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction modelGuanqiang YanJingxiao LiYiji SuGuosheng LiGuiyu FengJun LiuXiang GaoHuafu ZhouObjectiveThis study aimed to explore the risk factors of hypokalemia after radical resection of esophageal cancer (EC) and establish a nomogram risk prediction model to evaluate hypokalemia risk after esophagectomy. Thus, this study provides a reference for the clinical development of intervention measures.MethodsClinical data of EC patients who underwent radical surgery from January 2020 to November 2022 in the First Affiliated Hospital of Guangxi Medical University were retrospectively collected. The relevant variables were screened using multivariate logistic regression analysis with IBM SPSS 25.0 and R 4.2.0 software, and a nomogram for predicting hypokalemia risk was established. The established nomogram was evaluated by receiver operating characteristic (ROC), calibration, and decision curves. The model was also internally validated by 1000 bootstrap resampling methods.ResultsAfter radical EC resection, the incidence rate of hypokalemia in 213 patients was 19.2% (41/213). The hemoglobin levels, total serum protein, serum albumin, calcium ion concentration, direct bilirubin, prothrombin time (PT), and activated partial thromboplastin time (APTT) were related (p < 0.05). The multivariate logistic analysis showed that the white blood cell count, serum albumin level, direct bilirubin, and operation time were risk factors for hypokalemia after radical EC resection (p < 0.05). The area under the ROC curve (AUC) was 0.764, demonstrating the good discriminative ability of the established nomogram for hypokalemia prediction. The calibration curve showed a good fit between the predicted and actual observed probabilities. The model maintained a high C-index in the internal validation (C-index = 0.758), supporting that the nomogram can be widely used for hypokalemia prediction.ConclusionThe prediction model for hypokalemia risk with individualized scores based on the patient's white blood cell count, serum albumin level, direct bilirubin, and operation time can screen out high-risk patients who might develop hypokalemia. It is of certain reference value for clinicians to screen and follow up with patients with emphasis and to formulate preoperative and postoperative intervention strategies.https://www.frontiersin.org/articles/10.3389/fsurg.2024.1433751/fullesophageal cancerradical resection of esophagus cancerhypokalemiaprediction modelnomogram
spellingShingle Guanqiang Yan
Jingxiao Li
Yiji Su
Guosheng Li
Guiyu Feng
Jun Liu
Xiang Gao
Huafu Zhou
Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
Frontiers in Surgery
esophageal cancer
radical resection of esophagus cancer
hypokalemia
prediction model
nomogram
title Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
title_full Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
title_fullStr Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
title_full_unstemmed Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
title_short Risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
title_sort risk factors analysis of hypokalemia after radical resection of esophageal cancer and establishment of a nomogram risk prediction model
topic esophageal cancer
radical resection of esophagus cancer
hypokalemia
prediction model
nomogram
url https://www.frontiersin.org/articles/10.3389/fsurg.2024.1433751/full
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