Preoperative Blood Glucose Level Predicts Postsurgical Gastroparesis Syndrome after Subtotal Gastrectomy: Development of an Individualized Usable Nomogram

Background. Postsurgical gastroparesis syndrome (PGS) after subtotal gastrectomy imposes significant social and economic burdens. We aimed to investigate the relationship between preoperative blood glucose level and PGS and develop a nomogram for individualized prediction. Patients and Methods. We r...

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Bibliographic Details
Published in:	Journal of diabetes research 2020, Vol.2020, p.7058145-7
Main Authors:	Mao, Chenchen, Liu, Xin, Huang, Yunshi, Shi, Mingming, Meng, Weiyang, Xu, Libin, Chen, Weisheng, Hu, Yuanbo, Yang, Xinxin, Chen, Xiaodong, Shen, Xian
Format:	Article
Language:	eng
Subjects:	Adult Aged Aged, 80 and over Blood Glucose - analysis Blood Glucose - metabolism Body mass index China Diabetes Diabetes Complications - blood Diabetes Complications - diagnosis Diabetes Complications - surgery Fasting - blood Female Gastrectomy - adverse effects Gastrectomy - methods Gastric Stump - physiopathology Gastroparesis - blood Gastroparesis - diagnosis Gastroparesis - etiology Glucose Hospitals Humans Hyperglycemia Hypertension Hypoglycemia Individuality Male Middle Aged Multivariate analysis Nomograms Patients Postoperative Complications - blood Postoperative Complications - diagnosis Postoperative Complications - etiology Preoperative Period Prognosis Regression analysis Retrospective Studies Stomach cancer Stomach Neoplasms - blood Stomach Neoplasms - diagnosis Stomach Neoplasms - surgery Studies Syndrome Treatment Outcome
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Summary:	Background. Postsurgical gastroparesis syndrome (PGS) after subtotal gastrectomy imposes significant social and economic burdens. We aimed to investigate the relationship between preoperative blood glucose level and PGS and develop a nomogram for individualized prediction. Patients and Methods. We retrospectively analyzed 633 patients with gastric cancer who underwent subtotal gastrectomy. Preoperative blood glucose levels were evaluated via receiver operating characteristic (ROC) curve analysis. Chi-squared tests and multivariable logistic regression analyses were used to develop a predictive model for PGS, presented as a nomogram, which was assessed for its clinical usefulness. Results. Thirty-eight of 633 patients were diagnosed with PGS. Based on the ROC curve analysis, the preoperative blood glucose cutoff value for PGS was 6.25 mmol/L. The predictors of PGS included preoperative hyperglycemia (odds ratio (OR) 2.3, P=0.03), body mass index (BMI; OR 0.21, P=0.14 for BMI24), and the anastomotic method (OR 7.3, P=0.001 for Billroth II and OR 5.9, P=0.15 for Roux-en-Y). The predictive model showed good discrimination ability, with a C-index of 0.710, and was clinically useful. Conclusions. Preoperative hyperglycemia effectively predicts PGS. We present a nomogram incorporating the preoperative blood glucose level, BMI, anastomotic method, and tumor size, for individualized prediction of PGS.
ISSN:	2314-6745 2314-6753