BACKGROUND Postoperative intra-abdominal infectious complication (PIIC) after gastrectomy for gastric cancer worsens in-hospital death or long-term survival. However, the methodology for PIIC preoperative risk assessment remains unestablished. We aimed to develop a preoperative risk model for postgastrectomy PIIC. METHODS We collected 183,936 patients' data on distal or total gastrectomy performed in 2013-2016 for gastric cancer from the Japanese National Clinical Database and divided into development (2013-2015; n = 140,558) and validation (2016; n = 43,378) cohort. The primary outcome was the incidence of PIIC. The risk model for PIIC was developed using 18 preoperative factors: age, sex, body mass index, activities of daily living, 12 comorbidity types, gastric cancer stage, and surgical procedure in the development cohort. Secondarily, we developed another model based on the new scoring system for clinical use using selected factors. RESULTS The overall incidence of PIIC was 4.7%, including 2.6%, 1.7%, and 1.3% in anastomotic leakage, pancreatic fistula, and intra-abdominal abscess, respectively. Among the 18 preoperative factors, male [odds ratio, (OR) 1.92], obesity (OR, 1.52-1.96), peripheral vascular disease (OR, 1.55), steroid use (OR, 1.83), and total gastrectomy (OR, 1.89) strongly correlated with PIIC incidence. The entire model using the 18 factors had good discrimination and calibration in the validation cohort. We selected eight relevant factors to create a simple scoring system, using which we categorized the patients into three risk groups, which showed good calibration. CONCLUSION Using nationwide clinical practice data, we created a preoperative risk model for postgastrectomy PIIC for gastric cancer.

中文翻译：

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使用日本基于网络的全国数据库研究胃癌胃切除术后腹腔内感染并发症的术前危险因素。

背景 胃癌胃切除术后的腹腔内感染并发症 (PIIC) 会加重院内死亡或长期生存。然而，PIIC 术前风险评估的方法仍未建立。我们旨在开发胃切除术后 PIIC 的术前风险模型。方法 我们从日本国家临床数据库中收集了 2013-2016 年对胃癌进行的远端或全胃切除术的 183,936 名患者的数据，并将其分为开发（2013-2015；n = 140,558）和验证（2016；n = 43,378）队列。主要结果是 PIIC 的发生率。PIIC 的风险模型是使用 18 个术前因素开发的：年龄、性别、体重指数、日常生活活动、12 种合并症类型、胃癌分期和开发队列中的手术程序。其次，我们开发了另一个基于新评分系统的模型，用于使用选定的因素进行临床使用。结果 PIIC的总发生率为4.7%，其中吻合口瘘、胰瘘和腹腔脓肿的发生率分别为2.6%、1.7%和1.3%。在 18 个术前因素中，男性 [比值比 (OR) 1.92]、肥胖 (OR, 1.52-1.96)、外周血管疾病 (OR, 1.55)、类固醇使用 (OR, 1.83) 和全胃切除术 (OR, 1.89) ) 与 PIIC 发生率密切相关。使用 18 个因子的整个模型在验证队列中具有良好的辨别力和校准能力。我们选择了八个相关因素来创建一个简单的评分系统，使用该系统我们将患者分为三个风险组，这显示出良好的校准。结论 使用全国临床实践数据，