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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1416888
The Clinical Outcome of Minor Changes in Serum Creatinine for Patients After Curative Gastrectomy: A Prospective Study
Provisionally accepted- 1 First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- 2 Department of Gastrointestinal Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
Introduction: Patients with renal insufficiency are more prone to postoperative complications (PCs). Studies have shown that minor changes in serum creatinine (SCr), immediately post-surgery, can aid in assessing patients' renal function. This study aimed to explore the relationship between the changes in SCr and PCs in patients with gastric cancer (GC).We prospectively collected data regarding the SCr of 530 GC patients, within 2 weeks before surgery and within 24 hours after surgery in our hospital (2014)(2015)(2016). The patients were divided into three groups according to the level of SCr change after surgery: reduced (<10%), normal (10%), and elevated (>10%) creatinine groups. Univariate and multivariate logistic analysis were performed to evaluate its correlation with short-term PCs in the patients. The R language was used to construct a nomogram.Results: Eighty-three, 217, and 230 patients were assigned to the elevated, reduced, and normal SCr groups, respectively. Multivariate analysis showed that the reduced and elevated SCr groups were independently associated with the occurrence of PCs and severe postoperative complications (SPCs), respectively. Additionally, postsurgical SCr change, age, hypoalbuminemia, total gastrectomy, combined resection, and laparoscopy, were independently related to PCs. Combining the above influential factors, the predictive model can distinguish patients with PCs more reliably (c-index is 0.715).Post-surgery, reduced SCr is a protective factor for PCs, while elevated serum creatinine is an independent risk factor for SPCs. Our nomogram can identify GC patients with high risks of PCs.
Keywords: gastric cancer, serum creatinine changes, postoperative outcomes, nomogram, prospective study
Received: 25 Apr 2024; Accepted: 29 Jul 2024.
Copyright: © 2024 Cai, Zeng, Huang, Chen, Chen and Xie. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiu-Ya Zeng, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
Wei-Sheng Chen, Department of Gastrointestinal Surgery, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
Xiangjian Chen, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
Xian-Hai Xie, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, Zhejiang Province, China
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