Construction and validation of a prediction model for postoperative complications of elderly patients with locally advanced esophageal squamous cell carcinoma based on POSSUM system and inflammatory factors

To explore the efficacy of physiological and surgical invasion score (POSSUM) system and inflammatory factors in predicting postoperative complications of elderly patients with locally advanced esophageal squamous cell carcinoma, and to construct and verify the prediction model accordingly. Patients were randomly assigned to training set and verification set according to the ratio of 7:3. In the training set, multivariate Logistic regression analysis was used to deeply analyze the related risk factors of postoperative complications, including POSSUM system scoring factors and inflammatory factors, to build a prediction model of postoperative complications, and to draw ROC curves and calibration curves to evaluate the prediction efficiency of the model. The model was verified in the verification set, and the clinical application value of the prediction model was evaluated by decision curve analysis (DCA). There was no significant difference in the incidence of complications and clinical data between the two groups (P > 0.05). Multivariate Logistic regression model analysis showed that age, POSSUM physiological score, POSSUM surgical severity score, CRP, TNF-α and IL-6 were independent risk factors for postoperative complications in elderly patients with locally advanced esophageal squamous cell carcinoma (P < 0.05). The prediction model based on the above risk factors shows excellent prediction performance in both the training set and the verification set, and its C-index reaches 0.860 and 0.655 respectively. The results of Hosmer-Lemeshow test verify the applicability of the model in the training set and verification set (χ2 = 9.606, P = 0.293 and χ2 = 4.094, P = 0.848). The ROC curve shows that the predictive model has high clinical predictive efficacy of 0.863 (95% CI: 0.0.778–0.948) and 0.669 (95% CI: 0.442–0.897), and its sensitivity and specificity are 0.818 and 0.897, respectively. The prediction model of postoperative complications of elderly patients with locally advanced esophageal squamous cell carcinoma based on POSSUM system and inflammatory factors level has good prediction efficiency, which can provide solid basis and strong support for clinical decision-making, help to reduce the risk of postoperative complications and improve the quality of life of patients.