title: Nomogram Estimating the Probability of Intraabdominal Abscesses after Gastrectomy in Patients with Gastric Cancer.
abstract: OBJECTIVE
  Intraabdominal abscess is one of the most common reasons for re-hospitalization after gastrectomy. This study aimed to develop a model for estimating the probability of intraabdominal abscesses that can be used during the postoperative period.
  
  
  METHODS
  We retrospectively reviewed the clinicopathological data of 1,564 patients who underwent gastrectomy for gastric cancer between 2010 and 2012. Twenty-six related markers were analyzed, and multivariate logistic regression analysis was used to develop the probability estimation model for intraabdominal abscess. Internal validation using a bootstrap approach was employed to correct for bias, and the model was then validated using an independent dataset comprising of patients who underwent gastrectomy between January 2008 and March 2010. Discrimination and calibration abilities were checked in both datasets.
  
  
  RESULTS
  The incidence of intraabdominal abscess in the development set was 7.80% (122/1,564). The surgical approach, operating time, pathologic N classification, body temperature, white blood cell count, C-reactive protein level, glucose level, and change in the hemoglobin level were significant predictors of intraabdominal abscess in the multivariate analysis. The probability estimation model that was developed on the basis of these results showed good discrimination and calibration abilities (concordance index=0.828, Hosmer-Lemeshow chi-statistic P=0.274). Finally, we combined both datasets to produce a nomogram that estimates the probability of intraabdominal abscess.
  
  
  CONCLUSIONS
  This nomogram can be useful for identifying patients at a high risk of intraabdominal abscess. Patients at a high risk may benefit from further evaluation or treatment before discharge.
authors.affiliation: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Bang Wool
authors.initials: BW
authors.lastname: Eom
authors.affiliation: Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Jungnam
authors.initials: J
authors.lastname: Joo
authors.affiliation: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Biometric Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Boram
authors.initials: B
authors.lastname: Park
authors.affiliation: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Hong Man
authors.initials: HM
authors.lastname: Yoon
authors.affiliation: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
authors.affiliation: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors.forename: Soo Jin
authors.initials: SJ
authors.lastname: Kim
keywords: Abdominal abscess; Nomograms; Postoperative complications; Stomach neoplasms
references.citation: Dis Colon Rectum. 1996 Jun;39(6):654-8
references.pmid: 8646952
references.citation: J Clin Oncol. 2004 Jul 15;22(14):2767-73
references.pmid: 15199090
references.citation: Br J Cancer. 2003 Nov 3;89(9):1599-604
references.pmid: 14583755
references.citation: Lancet. 1996 Apr 13;347(9007):995-9
references.pmid: 8606613
references.citation: Br J Surg. 2012 Dec;99(12):1681-7
references.pmid: 23034831
references.citation: Br J Surg. 2014 Feb;101(3):239-45
references.pmid: 24281922
references.citation: Gastric Cancer. 2011 Jun;14(2):113-23
references.pmid: 21573742
references.citation: Stat Med. 1996 Feb 28;15(4):361-87
references.pmid: 8668867
references.citation: J Gastric Cancer. 2013 Jun;13(2):98-105
references.pmid: 23844324
references.citation: Ann Surg. 2009 Aug;250(2):177-86
references.pmid: 19638919
references.citation: Ann Surg. 1997 Nov;226(5):613-20
references.pmid: 9389395
references.citation: J Gastric Cancer. 2012 Mar;12(1):13-7
references.pmid: 22500259
references.citation: Br J Surg. 2005 Sep;92(9):1099-102
references.pmid: 15931657
references.citation: Ann Surg Oncol. 2008 Jun;15(6):1625-31
references.pmid: 18340493
references.citation: Br J Surg. 2001 Oct;88(10):1344-5
references.pmid: 11578289
references.citation: Surg Endosc. 2012 May;26(5):1287-95
references.pmid: 22044981
references.citation: Lancet. 1995 Mar 25;345(8952):745-8
references.pmid: 7891484
references.citation: Br J Surg. 1998 Feb;85(2):209-12
references.pmid: 9501818
references.citation: J Clin Oncol. 2004 Jun 1;22(11):2069-77
references.pmid: 15082726
references.citation: Br J Surg. 2010 Oct;97(10):1547-51
references.pmid: 20665480
references.citation: J Gastric Cancer. 2011 Jun;11(2):116-21
references.pmid: 22076212
references.citation: Ann R Coll Surg Engl. 2013 Jul;95(5):323-8
references.pmid: 23838493
references.citation: Infect Control Hosp Epidemiol. 2014 Feb;35(2):152-7
references.pmid: 24442077
references.citation: Ann Surg. 2010 Mar;251(3):417-20
references.pmid: 20160637
references.citation: JAMA. 1993 Dec 22-29;270(24):2957-63
references.pmid: 8254858
references.citation: Br J Surg. 2007 Jun;94(6):743-8
references.pmid: 17330836
references.citation: Support Care Cancer. 2014 Feb;22(2):527-35
references.pmid: 24141699
references.citation: Am J Surg. 2008 Nov;196(5):741-5
references.pmid: 18954604
references.citation: Intensive Care Med. 1996 Jul;22(7):707-10
references.pmid: 8844239
references.citation: J Gastric Cancer. 2013 Mar;13(1):34-43
references.pmid: 23610717
references.citation: Am J Surg. 2014 Mar;207(3):346-51; discussion 350-1
references.pmid: 24439160
references.citation: Gastric Cancer. 2008;11(2):81-5
references.pmid: 18595014
references.citation: Br J Surg. 1991 Mar;78(3):355-60
references.pmid: 2021856
references.citation: Gastric Cancer. 2004;7(4):254-9
references.pmid: 15616774
references.citation: Br J Surg. 2004 Mar;91(3):283-7
references.pmid: 14991627
references.citation: Crit Care Med. 1985 Oct;13(10):818-29
references.pmid: 3928249