A novel nomogram based on nutritional and immune status predicting postoperative intra-abdominal infection in colorectal cancer

Background and Objectives: This study aimed to investigate independent risk factors for intra-abdominal infection and to construct a nomogram to identify colorectal patients at a high risk of intra-abdominal infection. Methods and Study Design: Clinical data of patients undergoing radical resection of colorectal cancer from January 2019 to December 2021 were retrospectively included in this study. Patients were divided into two groups according to postoperative intra-abdominal infection. Clinicopathological indicators, intraoperative conditions, and postoperative complications were compared between the two groups, logistic regression was used to look for independent risk factors for intra-abdominal infection, and a nomogram was constructed based on independent risk factors. Results: 402 colorectal cancer patients were enrolled in this study, and 46 patients (11.4%) developed intra-abdominal infections after surgery. The independent risk factors for intra-abdominal infection were preoperative albumin, lymphocyte-white cell ratio (LWR) <0.17, low subcutaneous fat mass, and low skeletal muscle mass. The nomogram model for intra-abdominal infection was able to reliably quantify the risk of intraabdominal infection with strong optimism-adjusted discrimination (concordance index=0.931). Furthermore, decision curve analysis showed that the nomogram was clinically useful and had a better discriminative ability to recognize patients at high risk than the risk factors alone. Conclusions: In conclusion, we found that preoperative albumin, LWR <0.17, low subcutaneous fat mass, and low skeletal muscle mass were significantly correlated with intra-abdominal infection. Our nomogram was a simple and practical instrument to quantify the individual risk of intra-abdominal infection.