Volume 24 Issue 5
May  2026
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2026  >  24(5): 759-763
GU Rong, SHEN Ruting, JIANG Lu, YANG Yang, YE Xianghong, HUANG Xiaopeng. The influencing factors and development of a prediction model for postoperative enteral nutrition intolerance in colorectal cancer[J]. Chinese Journal of General Practice, 2026, 24(5): 759-763. doi: 10.16766/j.cnki.issn.1674-4152.004485
Citation: GU Rong, SHEN Ruting, JIANG Lu, YANG Yang, YE Xianghong, HUANG Xiaopeng. The influencing factors and development of a prediction model for postoperative enteral nutrition intolerance in colorectal cancer[J]. Chinese Journal of General Practice, 2026, 24(5): 759-763. doi: 10.16766/j.cnki.issn.1674-4152.004485
shu

The influencing factors and development of a prediction model for postoperative enteral nutrition intolerance in colorectal cancer

doi: 10.16766/j.cnki.issn.1674-4152.004485

  • Department of General Surgery, Eastern Theater Command General Hospital, Nanjing, Jiangsu 210002, China

Funds:

 BK20241676

 18CXZ040

  • Received Date: 2025-05-13
    Available Online: 2026-10-23
    Abstract
  •   Objective  To develop a nomogram for predicting the risk of enteral nutrition intolerance after colorectal cancer surgery and to preliminarily validate the predictive performance.  Methods  A retrospective analysis was conducted on 185 colorectal cancer patients who underwent surgical treatment at the General Hospital of Eastern Theater Command from January 2021 to June 2024. All patients received postoperative enteral nutrition support. Based on the presence of intolerance symptoms, patients were divided into the tolerance group (n=129) and the intolerance group (n=56). The clinical data of the two groups were collected, including demographic indicators, colorectal cancer conditions, surgical data, and postoperative enteral nutrition-related conditions. Multivariate logistic regression analysis was used to identify the influencing factors for postoperative enteral nutrition intolerance. A nomogram prediction model was then constructed based on these factors. The discrimination and calibration of the model were verified by the receiver operating characteristic (ROC) curve and calibration curve.  Results  Advanced age, presence of nutritional risk, postoperative bed rest time ≥ 3 days, initiation of enteral nutrition ≥ 48 hours, and use of analgesic drugs were identified as risk factors for postoperative enteral nutrition intolerance, while dietary fiber supplementation was a protective factor. A nomogram model incorporating these variables was developed. The model demonstrated good discrimination, with a C-index of 0.808. The calibration curves showed good agreement between predicted and observed outcomes. The AUC for the nomogram predicting postoperative enteral nutrition intolerance in colorectal cancer was 0.823 (95% CI: 0.760-0.885), indicating satisfactory predictive efficacy.  Conclusion  The nomogram prediction model constructed based on influencing factors such as age and nutritional risk demonstrates good discrimination and consistency, and can serve as an effective tool for predicting postoperative enteral nutrition intolerance in colorectal cancer patients.

     

    • FullText(HTML)
  • loading
    • References(18)
  • [1]
    ZHENG R S, ZHANG S W, ZENG H M, et al. Cancer incidence and mortality in China, 2016[J]. J Natl Cancer Cent, 2022, 2(1): 1-9.
    [2]
    BRAY F, LAVERSANNE M, SUNG H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263.
    [3]
    张丽华, 张莉, 张丽萍, 等. 脓毒症患者肠内营养喂养不耐受现况及影响因素研究[J]. 华南预防医学, 2023, 49(2): 174-178.

    ZHANG L H, ZHANG L, ZHANG L P, et al. Enteral nutrition feeding intolerance and its influencing factors in patients with sepsis[J]. South China Journal of Preventive Medicine, 2023, 49(2): 174-178.
    [4]
    中华医学会外科学分会结直肠外科学组, 张忠涛, 董明, 等. 中国结直肠癌手术病人营养治疗指南(2025版)[J]. 中国实用外科杂志, 2025, 45(2): 137-148.

    The Colorectal Surgery Group of the Surgical Branch of the Chinese Medical Association, ZHANG Z T, DONG M, et al. China nutritional therapy guidelines for colorectal cancer surgery patients(2025 edition)[J]. Chinese Journal of Practical Surgery, 2025, 45(2): 137-148.
    [5]
    BUKOWSKI J S, DEMBIÑSKI, DZIEKIEWICZ M, et al. Early enteral nutrition in paediatric acute pancreatitis: a review of published studies[J]. Nutrients, 2022, 14(16): 3441. DOI: 10.3390/nu14163441.
    [6]
    倪荣, 陈颖颖, 左玲, 等. 危重患者肠内营养喂养不耐受现况及影响因素研究[J]. 华南预防医学, 2022, 48(9): 1140-1142.

    NI R, CHEN Y Y, ZUO L, et al. Status and influencing factors of enteral nutrition intolerance in critically ill patients[J]. South China Journal of Preventive Medicine, 2022, 48(9): 1140-1142.
    [7]
    VAN SMEDEN M, REITSMA J B, RILEY R D, et al. Clinical prediction models: diagnosis versus prognosis[J]. J Clin Epidemiol, 2021, 132: 142-145. doi: 10.1016/j.jclinepi.2021.01.009
    [8]
    中华人民共和国国家卫生健康委员会. 中国结直肠癌诊疗规范(2020年版)[J]. 中华外科杂志, 2020, 58(8): 561-585.

    The National Health Commission of the People's Republic of China. Protocol of Diagnosis and Treatment of Colorectal Cancer(2020 edition)[J]. Chinese Journal of Surgery, 2020, 58(8): 561-585.
    [9]
    REINTAM BLASER A, DEANE A M, PREISER J C, et al. Enteral feeding intolerance: updates in definitions and pathophysiology[J]. Nutr Clin Pract, 2021, 36(1): 40-49. doi: 10.1002/ncp.10599
    [10]
    JENKINS B, CALDER P C, MARINO L V. A systematic review of the definitions and prevalence of feeding intolerance in critically ill adults[J]. Clin Nutr ESPEN, 2022, 49: 92-102. doi: 10.1016/j.clnesp.2022.04.014
    [11]
    钟明霞, 傅聿铭, 吴万庆, 等. 早期肠内营养对结肠癌根治术后患者营养状态及消化道功能恢复的影响[J]. 癌症进展, 2020, 18(3): 317-320.

    ZHONG M X, FU Y M, WU W Q, et al. The effect of early enteral nutrition on the nutritional status and recovery of gastrointestinal tract function in patients with radical colectomy[J]. Oncology Progress, 2020, 18(3): 317-320.
    [12]
    赵敏, 桑畅野, 闫长红. EEN+PN方案对直肠癌根治术围手术期患者营养和免疫指标及康复的影响[J]. 中华全科医学, 2022, 20(9): 1587-1589, 1611. doi: 10.16766/j.cnki.issn.1674-4152.002655

    ZHAO M, SANG C Y, YAN C H. Effect of EEN and PN scheme on the nutrition indicators, immunological function and rehabilitationin patients undergoing laparoscopic colorectal surgery[J]. Chinese Journal of General Practice, 2022, 20(9): 1587-1589, 1611. doi: 10.16766/j.cnki.issn.1674-4152.002655
    [13]
    赵成, 胡丽娜, 喻慧, 等. 肠内营养支持对转移性结直肠癌患者生存质量及疗效的影响分析[J]. 中华内分泌外科杂志(中英文), 2024, 18(4): 578-582.

    ZHAO C, HU L N, YU H, et al. Effect of enteral nutrition support on quality of life and therapeutic effect in patients with metastatic colorectal cancer[J]. Chinese Journal of Endocrine Surgery, 2024, 18(4): 578-582.
    [14]
    STANNARD D. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications[J]. J Perianesth Nurs, 2020, 35(5): 541-542. doi: 10.1016/j.jopan.2020.07.003
    [15]
    WANG W Y, CHEN C W, WANG T J, et al. Outcomes of early enteral feeding in patients after curative colorectal cancer surgery: a retrospective comparative study[J]. Eur J Oncol Nurs, 2021, 54: 101970. DOI: 10.1016/j.ejon.2021.101970.
    [16]
    曾佳琪, 张博, 苏红辉. 口腔颌面部恶性肿瘤患者肠内营养喂养不耐受状况及影响因素[J]. 南方医科大学学报, 2021, 41(7): 1114-1118.

    ZENG J Q, ZHANG B, SU H H. Incidence of enteral feeding intolerance and its risk factors in patients with oral and maxillofacial malignancies[J]. Journal of Southern Medical University, 2021, 41(7): 1114-1118.
    [17]
    ZHANG Y N, MA D D, LANG B, et al. Effect of opioid-free anesthesia on the incidence of postoperative nausea and vomiting: a meta-analysis of randomized controlled studies[J]. Medicine, 2023, 102(38): e35126. DOI: 10.1097/MD.0000000000035126.
    [18]
    XIAO Y J, XU L. Prevalence and risk factors of enteral feeding intolerance in critically ill patients and the effectiveness of preventive treatments: a prospective study[J]. Saudi J Med Med Sci, 2023, 11(2): 135. DOI: 10.4103/sjmms.sjmms_384_22.
    • Relative Articles
    • Supplements(0)
    • Cited By

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (11) PDF downloads(1) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return