A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers

A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers Yanfei Yang, Qi Zhang, Guang Tan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4153946/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract 1.1Objective According to relevant studies, the incidence of pancreatic tumors has increased in both Asian and Western countries [1]. Surgical resection is the cornerstone of treatment for this aggressive disease [2] [3]. According to relevant studies, postoperative pancreatic fistula (POPF) in pancreatic tumors is one of the most serious complications after surgery, which seriously affects the course of patients' treatment and their prognosis [2] [3]. In the present study, we aime to identify the risk factors associated with clinically relevant postoperative pancreatic fistula (CR-POPF) based on systemic inflammatory markers (SIB), and preoperative, intraoperative, and postoperative dimensions, and to establish a multidimensional columnar graphical model for predicting postoperative pancreatic fistula (POPF) in pancreatic tumors [4] [5]. 1.2Methods Ninety patients who underwent surgery for pancreatic tumors at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Dalian Medical University between November 21, 2022 and November 21, 2023 were retrospectively studied. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University, and the relevant guidelines and regulations have been strictly followed.The collected clinical data were first processed by feature engineering and analyzed with relevant statistics such as chi-square test according to the criteria described in the Supplementary file, and risk factors with P-Value ≤ 0.05 were selected. Then, the data set was randomly divided into training set and validation set according to 7:3, and then batch one-way logistic regression analysis was performed and risk factors with P-Value ≤ 0.05 were selected, and then multifactorial logistic regression analysis was performed and the optimal multivariate regression model was constructed. Based on the results of multifactors logistic regression analysis, a multidimensional column-line diagram was developed . The Bootstrap method was used to validate the model in a relevant way, and the predictive performance was assessed using the subject work characteristics (ROC) curve, and the clinical application value of the model was verified using the decision curve analysis (DCA) and calibration (Calibration) curve. 1.3Results The incidence of POPF in this study was 50.0% (45/90). Multivariate logistic regression analysis identified the following variables as independent risk factors for POPF: preoperative albumin level (ALB, OR:5.06,P=0.012 ), neutrophil to lymphocyte ratio ( NLR, OR: 9.55,P < 0.001 ), and systemic immunoinflammatory markers ( SII, OR: 0.006,P =4.58 ), the ratio of amylase concentration in drainage fluid to preoperative blood amylase concentration ( DSAR, OR=26.73,P < 0.001 ). We create a multi-dimensional nomogram by combining the above risk factors. The multidimensional nomogram model shows better predictive value. AUC under receiver Operating characteristic (ROC) curve: training set AUC=0.889 > 0.50 , validation set AUC=0.949 > 0.50 . The results show that the multidimensional nomogram model has good predictive performance, and the DCA and Calibration analyses of training set and validation set also show that the multidimensional nomogram model has higher clinical net benefit and better fit. 1.4Conclusion Based on SIB, the column diagram we constructed can scientifically, accurately and objectively predict the risk of POPF in patients after pancreatic tumor surgery, which can better assist clinicians to conduct scientific POPF risk assessment on patients about to undergo pancreatic tumor surgery, and timely conduct relevant clinical intervention, so as to better develop the mitigation strategy of pancreatic fistula and corresponding postoperative management. The quality of life and prognosis of patients after operation were improved. Health sciences/Medical research Health sciences/Oncology POPF Pancreatic tumor surgery Multidimensional Nomogram Full Text Additional Declarations No competing interests reported. Supplementary Files Abbreviation.doc Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4153946","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":291915693,"identity":"161e157d-b350-4f0e-9cd4-e66e4297018a","order_by":0,"name":"Yanfei Yang","email":"","orcid":"","institution":"The First Affiliated Hospital of Dalian Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yanfei","middleName":"","lastName":"Yang","suffix":""},{"id":291915694,"identity":"17e49e15-8a8c-46d7-bf33-9b21f6eead0b","order_by":1,"name":"Qi Zhang","email":"","orcid":"","institution":"The First Affiliated Hospital of Dalian Medical University","correspondingAuthor":false,"prefix":"","firstName":"Qi","middleName":"","lastName":"Zhang","suffix":""},{"id":291915695,"identity":"d0d2a2fa-943c-4b9f-bba7-c2850893783c","order_by":2,"name":"Guang Tan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIie3PMUvDQBTA8TsOcssLWV9Iab/ClYOoUMhXuVLoFERwaAeRVwLpIrhaEMFv4OR8BbFLPkBGY8H5Vhe1rg45R8H7j4/34/EYC4X+ZHz97uATikrsnFnicOQDwARlOBADJes5c82xHpOXSEKYiImCJuebejll1kOK5J4UlhEcYZnv4zs0nET32vZdwY7MWQNwcjNf6PgRTyWLtC57yZZseoXA2tlDdiDnnCDKPGRF8Yc6EKOy+BanZH0kWVUMwIBqnvJ0Q78hLa8FgoV0Xc+Ue0Y9rjy/yOvdG3dgi0SI7Yu5uByOZNXt+whD83Mi+ta/S6xvIxQKhf59X898SjjCkHdUAAAAAElFTkSuQmCC","orcid":"","institution":"The First Affiliated Hospital of Dalian Medical University","correspondingAuthor":true,"prefix":"","firstName":"Guang","middleName":"","lastName":"Tan","suffix":""}],"badges":[],"createdAt":"2024-03-23 10:32:30","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4153946/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4153946/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":59172834,"identity":"f71969fc-8c32-449c-b659-e6356fc9d0d3","added_by":"auto","created_at":"2024-06-27 08:48:52","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1364399,"visible":true,"origin":"","legend":"","description":"","filename":"PostoperativePancreaticFistulaPOPF.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4153946/v1_covered_a160f1d4-392e-42b8-b104-916e972e344d.pdf"},{"id":54850678,"identity":"37ec1f0f-3cc6-4aca-909a-726fc2b4ebca","added_by":"auto","created_at":"2024-04-17 16:18:50","extension":"doc","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":117822,"visible":true,"origin":"","legend":"","description":"","filename":"Abbreviation.doc","url":"https://assets-eu.researchsquare.com/files/rs-4153946/v1/74ecd5dab61df820a7aeed33.doc"}],"financialInterests":"No competing interests reported.","formattedTitle":"A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"POPF, Pancreatic tumor surgery, Multidimensional Nomogram","lastPublishedDoi":"10.21203/rs.3.rs-4153946/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4153946/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e1.1Objective\u003c/p\u003e\n\u003cp\u003eAccording to relevant studies, the incidence of pancreatic tumors has increased in both Asian and Western countries [1]. Surgical resection is the cornerstone of treatment for this aggressive disease [2] [3]. According to relevant studies, postoperative pancreatic fistula (POPF) in pancreatic tumors is one of the most serious complications after surgery, which seriously affects the course of patients' treatment and their prognosis [2] [3]. In the present study, we aime to identify the risk factors associated with clinically relevant postoperative pancreatic fistula (CR-POPF) based on systemic inflammatory markers (SIB), and preoperative, intraoperative, and postoperative dimensions, and to establish a multidimensional columnar graphical model for predicting postoperative pancreatic fistula (POPF) in pancreatic tumors [4] [5].\u003c/p\u003e\n\u003cp\u003e1.2Methods\u003c/p\u003e\n\u003cp\u003eNinety patients who underwent surgery for pancreatic tumors at the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Dalian Medical University between November 21, 2022 and November 21, 2023 were retrospectively studied. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Dalian Medical University, and the relevant guidelines and regulations have been strictly followed.The collected clinical data were first processed by feature engineering and analyzed with relevant statistics such as chi-square test according to the criteria described in the Supplementary file, and risk factors with \u003cem\u003eP-Value ≤ 0.05\u003c/em\u003ewere selected. Then, the data set was randomly divided into training set and validation set according to 7:3, and then batch one-way logistic regression analysis was performed and risk factors with \u003cem\u003eP-Value ≤ 0.05\u003c/em\u003e were selected, and then multifactorial logistic regression analysis was performed and the optimal multivariate regression model was constructed. Based on the results of multifactors logistic regression analysis, a multidimensional column-line diagram was developed . The Bootstrap method was used to validate the model in a relevant way, and the predictive performance was assessed using the subject work characteristics (ROC) curve, and the clinical application value of the model was verified using the decision curve analysis (DCA) and calibration (Calibration) curve.\u003c/p\u003e\n\u003cp\u003e1.3Results\u003c/p\u003e\n\u003cp\u003eThe incidence of POPF in this study was 50.0% (45/90). Multivariate logistic regression analysis identified the following variables as independent risk factors for POPF: preoperative albumin level\u003cem\u003e(ALB, OR:5.06,P=0.012\u003c/em\u003e), neutrophil to lymphocyte ratio (\u003cem\u003eNLR, OR: 9.55,P \u0026lt; 0.001\u003c/em\u003e), and systemic immunoinflammatory markers (\u003cem\u003eSII, OR: 0.006,P =4.58\u003c/em\u003e), the ratio of amylase concentration in drainage fluid to preoperative blood amylase concentration (\u003cem\u003eDSAR, OR=26.73,P \u0026lt; 0.001\u003c/em\u003e). We create a multi-dimensional nomogram by combining the above risk factors. The multidimensional nomogram model shows better predictive value. AUC under receiver Operating characteristic (ROC) curve: training set \u003cem\u003eAUC=0.889 \u0026gt; 0.50\u003c/em\u003e, validation set \u003cem\u003eAUC=0.949 \u0026gt; 0.50\u003c/em\u003e. The results show that the multidimensional nomogram model has good predictive performance, and the DCA and Calibration analyses of training set and validation set also show that the multidimensional nomogram model has higher clinical net benefit and better fit.\u003c/p\u003e\n\u003cp\u003e1.4Conclusion\u003c/p\u003e\n\u003cp\u003eBased on SIB, the column diagram we constructed can scientifically, accurately and objectively predict the risk of POPF in patients after pancreatic tumor surgery, which can better assist clinicians to conduct scientific POPF risk assessment on patients about to undergo pancreatic tumor surgery, and timely conduct relevant clinical intervention, so as to better develop the mitigation strategy of pancreatic fistula and corresponding postoperative management. The quality of life and prognosis of patients after operation were improved.\u003c/p\u003e","manuscriptTitle":"A nomogram for constructing a multidimensional postoperative pancreatic fistula for pancreatic tumors:Based on Systemic Inflammatory Biomarkers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-17 16:18:45","doi":"10.21203/rs.3.rs-4153946/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c465aca8-ebb9-48c5-aaa8-1f4be54eba32","owner":[],"postedDate":"April 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":30753892,"name":"Health sciences/Medical research"},{"id":30753893,"name":"Health sciences/Oncology"}],"tags":[],"updatedAt":"2024-06-27T08:40:42+00:00","versionOfRecord":[],"versionCreatedAt":"2024-04-17 16:18:45","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4153946","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4153946","identity":"rs-4153946","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}