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Peer-reviewedCC BYFrontiers in nutrition

Perioperative nutrition-related laboratory profiles predict outcomes after digestive procedures in patients with gastrointestinal cancer

  • Menghui Zhang1
  • Liangliang Hui2
  • Jialing Zhang1
  • Chengran Wang1
  • Fan Xu1
  • Guoquan Tao3
  • Honggang Wang1
  1. 1Department of Gastroenterology, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University , ,
  2. 2Department of Intensive Care Unit, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University , ,
  3. 3Department of Gastrointestinal Surgery, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University , ,
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Abstract

Routine laboratory measurements may capture nutritional, inflammatory, and organ-function vulnerability in patients with gastrointestinal cancer. We developed nested logistic regression models using INSPIRE v1.4.2 and evaluated a portable model in MIMIC-IV v3.1. The original INSPIRE cohort comprised 11,471 operations among 10,728 patients, with 893 deaths within 365 days. Patients were allocated to development and held-out test sets. For 365-day mortality, area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI 0.752-0.811) for clinical variables, 0.843 (95% CI 0.820-0.868) after adding laboratory variables, and 0.856 (95% CI 0.834-0.879) for the full perioperative model. Patient-level full-pipeline bootstrap analysis yielded an optimism-corrected AUROC of 0.837. External AUROC was 0.676 (95% CI 0.663-0.688) for 365-day mortality and 0.724 (95% CI 0.692-0.754) for recorded hospital death after harmonizing CRP units. Calibration drift was substantial, and hospital-death discrimination was sensitive to laboratory timing. Corrected operation-linked risk tertiles showed graded mortality and lower albumin and hemoglobin levels in higher-risk groups. Perioperative nutrition-related laboratory profiles provided additional discrimination for 365-day mortality beyond clinical variables, although limited external performance and calibration drift warrant further validation before clinical use.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026perioperative,
  title = {{Perioperative nutrition-related laboratory profiles predict outcomes after digestive procedures in patients with gastrointestinal cancer}},
  author = {Menghui Zhang and Liangliang Hui and Jialing Zhang and Chengran Wang and Fan Xu and Guoquan Tao and Honggang Wang},
  journal = {Frontiers in nutrition},
  year = {2026},
  month = oct,
  doi = {10.3389/fnut.2026.1927720},
  url = {https://europepmc.org/article/PMC/PMC13716669},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Perioperative nutrition-related laboratory profiles predict outcomes after digestive procedures in patients with gastrointestinal cancer
AU  - Menghui Zhang
AU  - Liangliang Hui
AU  - Jialing Zhang
AU  - Chengran Wang
AU  - Fan Xu
AU  - Guoquan Tao
AU  - Honggang Wang
PY  - 2026
DA  - 2026/10/15
JO  - Frontiers in nutrition
DO  - 10.3389/fnut.2026.1927720
UR  - https://europepmc.org/article/PMC/PMC13716669
AB  - Routine laboratory measurements may capture nutritional, inflammatory, and organ-function vulnerability in patients with gastrointestinal cancer. We developed nested logistic regression models using INSPIRE v1.4.2 and evaluated a portable model in MIMIC-IV v3.1. The original INSPIRE cohort comprised 11,471 operations among 10,728 patients, with 893 deaths within 365 days. Patients were allocated to development and held-out test sets. For 365-day mortality, area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI 0.752-0.811) for clinical variables, 0.843 (95% CI 0.820-0.868) after adding laboratory variables, and 0.856 (95% CI 0.834-0.879) for the full perioperative model. Patient-level full-pipeline bootstrap analysis yielded an optimism-corrected AUROC of 0.837. External AUROC was 0.676 (95% CI 0.663-0.688) for 365-day mortality and 0.724 (95% CI 0.692-0.754) for recorded hospital death after harmonizing CRP units. Calibration drift was substantial, and hospital-death discrimination was sensitive to laboratory timing. Corrected operation-linked risk tertiles showed graded mortality and lower albumin and hemoglobin levels in higher-risk groups. Perioperative nutrition-related laboratory profiles provided additional discrimination for 365-day mortality beyond clinical variables, although limited external performance and calibration drift warrant further validation before clinical use.
SN  - 2296-861X
ER  -