New scoring system for the evaluation obstructive degrees based on computed tomography for obstructive colorectal cancer

Table 1 Baseline characteristics of study patients stratified by computed tomography-based obstructive degree severity, n (%)

Characteristic	CTOD non-severe (CTOD 1-2)	CTOD severe (CTOD 3)	P value
PNP	0.0896	0.0689	0.405
P/D	4.080	7.120	< 0.001
Age (> 65 years)	71 (50.4)	15 (46.9)	0.722
Sex (female)	58 (41.1)	14 (43.8)	0.786
BMI (≥ 18.5 kg/m²)	108 (83.7)	23 (85.2)	0.850
ALB (≥ 35 g/L)	72 (51.1)	14 (43.8)	0.455
CEA (> 5ug/L)	71 (51.4)	18 (58.1)	0.505
Hb (< 9 g/L)	20 (14.2)	4 (12.5)	0.803
ASA 3-4	42 (29.8)	12 (37.5)	0.395
Surgical history	34 (24.1)	11 (34.3)	0.232
Comorbidities	79 (56.0)	18 (56.3)	0.982
SEMS	44 (31.2)	13 (40.6)	0.306
Left-sided	81 (57.4)	21 (65.6)	0.396
Surgical method			0.647
Stoma/SEMS	16 (11.4)	4 (12.5)
SBTS	33 (23.4)	10 (31.3)
Resection	92 (65.2)	18 (56.3)
Surgical time (minutes)	204.4	209.07	0.223
Bleeding (mL)	100	100	0.811
Total number of LN	19	19	0.675
Positive LN	1	1	0.184
Complication	62 (44.0)	21 (65.6)	0.027
SAE	20 (14.2)	5 (15.6)	0.834
Mortality within 30 days	1 (0.7)	0 (0.0)	1.000
Re-bowel obstruction	4 (2.8)	2 (6.3)	0.307
ICU stay	13 (9.2)	3 (9.4)	0.978
Pneumonia	21 (14.9)	11 (34.4)	0.010
Incision infection	21 (14.9)	3 (9.4)	0.415
pT 4 stage	51 (36.2)	11 (34.4)	0.981
pN 1-2 stage	81 (57.4)	18 (56.3)	0.981
pM 1 stage	42 (29.8)	5 (15.6)	0.104
Sepsis	5 (3.5)	1 (3.1)	1.000
Chemotherapy	74 (52.5)	14 (43.8)	0.502
Gas time (day)	3	3	0.869
Oral intake (day)	4	4	0.625
Total hospital stay (day)	19	25.5	0.004
Post-surgery stay (day)	12	12.5	0.021

CTOD: Computed tomography-based obstructive degree; PNP: Proportion of nonparenchymal areas at the site of obstruction; P/D: Proximal to distal obstruction; BMI: Body mass index; ALB: Albumin; CEA: Carcinoembryonic antigen; Hb: Hemoglobin; LN: Lymph node; ICU: Intensive care unit; ASA: American Society of Anesthesiologists; SAE: Serious adverse event; SEMS: Self-expandable metallic stents; SBTS: Stenting as bridge to surgery.

Table 2 The univariate and multivariate logistic regression analysis of complication

	Univariate			Multivariate
	OR	95%CI	P value	OR	95%CI	P value
CTOD (3 vs 1-2)	2.433	1.091-5.423	0.030	3.39	1.340-8.573	0.010
ALB (≥ 35 vs < 35)	0.934	0.514-1.696	0.882
Age (≥ 65yrs vs < 65)	1.707	0.935-3.117	0.082	NA	NA	NA
BMI (≥ 18.5 vs < 18.5)	0.521	0.215-1.264	0.149	NA	NA	NA
Surgical method
Only stoma/SEMS	1	Ref.	0.219	NA	NA	NA
SBTS	2.683	0.868-8.295	0.086
Surgical resection	2.25	0.806-6.282	0.122

CTOD: Computed tomography-based obstructive degree; BMI: Body mass index; ALB: Albumin; SEMS: Self-expandable metallic stents; SBTS: Stenting as bridge to surgery; OR: Odds ratio; CI: Confidence interval; NA: Not appliable.

Table 3 The interaction between the two classifications of severity of obstruction

	CROSS non-severe (CROSS 1-4)	CROSS severe (CROSS 0)	Cumulation
CTOD non-severe (CTOD 1-2)	93 (group D)	48 (group C)	141
CTOD severe (CTOD 3)	19 (group B)	13 (group A)	32
Cumulation	112	61	173

CTOD: Computed tomography-based obstructive degree; CROSS: Colorectal obstruction scoring system.

Table 4 Comparing the complication rates of emergency intervention in group A, B, C and D

Group	No-urgent intervention	Urgent intervention	P value
A	6/9 (66.7)	3/4 (75.0)	1.000
B	8/15 (53.3)	4/4 (100.0)	0.245
C	13/26 (50.0)	6/22 (27.3)	0.109
D	33/79 (41.8)	10/14 (71.4)	0.040