Construction of Predictive Model and Risk Stratification of Pulmonary Complications After Radical Resection of Colorectal Cancer in Elderly Patients
LI Zhe
LI Liantao
MIN Xinbo
LI Xingxing
Abstract：Objective To construct a risk stratification model for pulmonary complications(PPCs)after radical resection of colorectal cancer in the elderly,and to provide a reference for early prediction of PPCs risk probability.Methods A total of 206 elderly patients with colorectal cancer in Xinzheng Public People's Hospital from January 2022 to February 2025 were selected as the research objects.According to whether PPCs occurred within 30 days after radical resection of colorectal cancer,they were divided into a PPCs group and a non-PPCs group.The clinical data of the two groups were compared.Logistic regression was used to analyze the influencing factors of PPCs after radical resection of colorectal cancer in the elderly.R language was used to draw a nomogram,and the receiver operating characteristic(ROC)curve was drawn to evaluate and verify the effectiveness of the prediction model.A risk stratification system was established according to individual risk scores.Results The incidence of PPCs in 206 elderly patients with colorectal cancer was 26.21％.The age,body mass index(BMI),proportion of history of lung-related diseases,proportion of preoperative frailty,and assess respiratory risk in surgical patients in Catalonia(ARISCAT)score in the PPCs group were significantly higher than those in the non-PPCs group,and the albumin level was lower than that in the non-PPCs group(P＜0.05).Logistic regression analysis showed that BMI,history of lung-related diseases,preoperative frailty,and ARISCAT score were risk factors for PPCs in elderly patients with colorectal cancer,and albumin was a protective factor(P＜0.05).The area under the curve(AUC)of the model for predicting PPCs in elderly patients with colorectal cancer was 0.884(95％CI:0.832-0.824),and the sensitivity and specificity were 79.63％and 85.53％,respectively.The external validation showed that the AUC of the model for predicting PPCs was 0.878(95％CI:0.763-0.950),and the sensitivity and specificity were 93.75％and 80.00％,respectively.Risk stratification analysis showed that the risk of PPCs in elderly patients with colorectal cancer could be divided into six risk subgroups:very low risk group,low risk group,medium and low risk group,medium and high risk group,high risk group and very high risk group.Conclusion BMI,history of lung-related diseases,preoperative frailty,ARISCAT score and albumin are the influencing factors of PPCs in elderly patients with colorectal cancer.The prediction model and risk stratification system established based on this can provide theoretical basis for early identification and hierarchical management decision-making of PPCs high-risk groups.
Keywords：radical resection of colorectal cancerelderlypulmonary complicationsrisk stratificationinfluencing factorsprediction model
Publication Date：2026-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 837-842 )