Nomogram integrating systemic immune-inflammation index and blood lipid ratio to predict postoperative gastrointestinal dysfunction in elderly gallstone patients

Table 1 Comparison of baseline clinical characteristics between the modeling cohort and the model validation cohort, mean ± SD/n (%)

Indicator		Modeling cohort (n = 86)	Model validation cohort (n = 37)	t/χ2	P value
Age (years)		69.62 ± 6.65	69.24 ± 5.66	0.3031	0.762
Gender	Female	54 (62.79)	26 (70.27)	0.6362	0.425
	Male	32 (37.21)	11 (29.73)
Body mass index	< 18.5 kg/m2	26 (30.23)	13 (35.14)	0.3622	0.834
	18.5-24.0 kg/m2	33 (38.37)	14 (37.84)
	> 24.0 kg/m2	27 (31.40)	10 (27.03)
History of alcohol consumption		45 (52.33)	19 (51.35)	0.0102	0.921
Breakfast habit		44 (51.16)	21 (56.76)	0.3252	0.569
Exercise habit		49 (56.98)	17 (45.95)	1.2662	0.261
Stone diameter	≤ 1 cm	48 (55.81)	19 (51.35)	0.1612	0.698
	> 1 cm	38 (44.19)	18 (48.65)
Stone number	1 stone	52 (60.47)	17 (45.95)	2.2142	0.137
	> 3 stone	34 (39.53)	20 (54.05)
TC (mmol/L)		5.03 ± 0.33	5.10 ± 0.311	1.1721	0.244
HDL-C (mmol/L)		1.31 ± 0.15	1.33 ± 0.15	0.8091	0.420
SII		493.75 ± 84.19	483.71 ± 42.35	0.6881	0.493
TC/HDL-C		3.93 ± 0.75	3.90 ± 0.60	0.1991	0.843
Gallbladder wall thickness	> 5 mm	34 (39.53)	15 (40.54)	16.3982	0.089
	≤ 5 mm	52 (60.47)	22 (59.46)
Operation time (minutes)		34.92 ± 6.99	36.84 ± 6.35	1.4341	0.154
Neutrophil count (× 109/L)		3.98 ± 0.62	3.79 ± 0.58	1.5891	0.115
Lymphocyte count (× 109/L)		1.49 ± 0.41	1.36 ± 0.45	1.5661	0.120
Platelet count (× 109/L)		198.46 ± 32.93	199.67 ± 35.82	0.1821	0.856
TG (mmol/L)		1.32 ± 0.17	1.39 ± 0.23	1.8751	0.063
LDL-C (mmol/L)		2.89 ± 0.35	3.02 ± 0.32	1.9371	0.055
Time to ambulation after surgery	< 1 day	53 (61.63)	23 (62.16)	0.0032	0.955
	≥ 1 days	33 (38.37)	14 (37.84)

¹t-test.

²χ² test.

TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol ratio; SII: Systemic immune-inflammation index; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol.

Table 2 Comparison of clinical data between the poor and good gastrointestinal function groups in the modeling cohort, mean ± SD/n (%)

Indicator		Poor GI function group (n = 37)	Good GI function group (n = 49)	t/χ2	P value
Age (years)		69.46 ± 7.20	69.73 ± 6.28	0.1851	0.853
Gender	Female	25 (67.57)	29 (59.18)	0.6342	0.426
	Male	12 (32.43)	20 (40.82)
Body mass index	< 18.5 kg/m2	12 (32.43)	14 (28.57)	0.1662	0.920
	18.5-24.0 kg/m2	14 (37.84)	19 (38.78)
	> 24.0 kg/m2	11 (29.73)	16 (32.65)
History of alcohol consumption		15 (40.54)	30 (61.22)	3.6162	0.057
Breakfast habit		16 (43.24)	28 (57.14)	1.6302	0.202
Exercise habit		19 (51.35)	30 (61.22)	0.8382	0.360
Stone diameter	≤ 1 cm	20 (54.05)	28 (57.14)	0.0822	0.775
	> 1 cm	17 (45.95)	21 (42.86)
Stone number	1 stone	24 (64.86)	28 (57.14)	0.5262	0.468
	> 3 stone	13 (35.14)	21 (42.86)
TC (mmol/L)		5.16 ± 0.37	4.94 ± 0.26	2.9311	0.005
HDL-C (mmol/L)		1.28 ± 0.19	1.32 ± 0.10	1.4091	0.165
SII		494.04 ± 26.74	450.89 ± 20.41	8.7701	0.000
TC/HDL-C		4.16 ± 1.00	3.75 ± 0.40	2.3751	0.022
Gallbladder wall thickness	> 5 mm	23 (62.16)	11 (22.45)	28.2172	0.002
	≤ 5 mm	14 (37.84)	38 (77.55)
Operation time (minutes)			32.71 ± 1.08	3.1281	0.003
Neutrophil count (× 109/L)			3.26 ± 0.24	7.9521	0.000
Lymphocyte count (× 109/L)			1.32 ± 0.21	2.6781	0.009
Platelet count (× 109/L)			188.83 ± 24.95	0.9121	0.364
TG (mmol/L)			1.29 ± 0.18	1.9031	0.060
LDL-C (mmol/L)			2.84 ± 0.37	1.6981	0.093
Time to ambulation after surgery	< 1 day	16 (43.24)	37 (75.51)	9.2822	0.002
	≥ 1 days	21 (56.76)	12 (24.49)

¹t-test.

²χ² test.

TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol ratio; SII: Systemic immune-inflammation index; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; GI: Gastrointestinal.

Table 3 Logistic regression analysis of risk factors for poor postoperative gastrointestinal function in elderly gallstone patients

Factor	β	SE	Wald χ2	P value	OR	95%CI
						Lower limit	Upper limit
TC	2.154	0.108	34.824	0.534	1.563	0.888	2.238
SII	0.245	0.371	18.996	0.003	3.411	1.763	5.059
TC/HDL-C	3.416	0.327	12.072	0.025	1.628	1.387	1.869
Gallbladder wall thickness	1.909	0.373	26.524	0.046	1.524	1.167	1.881
Operation time	0.638	0.524	6.927	0.019	2.406	1.858	2.954
Neutrophil count	-0.375	0.635	5.374	0.542	1.542	0.793	2.291
Lymphocyte count	0.547	0.024	46.698	0.457	0.937	0.573	1.301
Time to ambulation after surgery	1.527	0.846	17.051	0.008	3.457	1.109	5.805

TC: Total cholesterol; SII: Systemic immune-inflammation index; HDL-C: High-density lipoprotein cholesterol ratio; OR: Odds ratio; CI: Confidence interval.

Table 4 Comparison of clinical data between the poor and good gastrointestinal function groups in the validation cohort, mean ± SD/n (%)

Indicator		Poor GI function group (n = 16)	Good GI function group (n = 21)	t/χ2	P value
Age (years)		70.06 ± 6.61	68.62 ± 4.90	0.7611	0.451
Gender	Female	11 (68.75)	15 (71.43)	0.0312	0.859
	Male	5 (31.25)	6 (28.57)
Body mass index	< 18.5 kg/m2	6 (37.50)	7 (33.33)	0.0892	0.957
	18.5-24.0 kg/m2	6 (37.50)	8 (38.10)
	> 24.0 kg/m2	4 (25.00)	6 (28.57)
History of alcohol consumption		6 (37.50)	13 (61.90)	2.1652	0.141
Breakfast habit		6 (37.50)	15 (71.43)	4.2592	0.052
Exercise habit		6 (37.50)	11 (52.38)	0.8102	0.368
Stone diameter	≤ 1 cm	8 (50.00)	11 (52.38)	0.0212	1.000
	> 1 cm	8 (50.00)	10 (47.62)
Stone number	1 stone	5 (31.25)	12 (57.14)	2.4512	0.185
	> 3 stone	11 (68.75)	9 (42.86)
TC (mmol/L)		5.37 ± 0.24	4.89 ± 0.15	7.3871	0.000
HDL-C (mmol/L)		1.29 ± 0.16	1.35 ± 0.14	1.2061	0.236
SII		488.90 ± 17.59	450.76 ± 18.93	6.2571	0.000
TC/HDL-C		4.22 ± 0.63	3.65 ± 0.45	3.1671	0.000
Gallbladder wall thickness	> 5 mm	10 (62.50)	5 (23.81)	5.6392	0.023
	≤ 5 mm	6 (37.50)	16 (76.19)
Operation time (minutes)		38.94 ± 8.93	35.37 ± 6.59	2.1871	0.031
Neutrophil count (× 109/L)		3.89 ± 0.34	3.68 ± 0.16	2.4981	0.017
Lymphocyte count (× 109/L)		1.58 ± 0.12	1.42 ± 0.28	2.1361	0.040
Platelet count (× 109/L)		191.32 ± 14.79	180.69 ± 19.83	1.7951	0.081
TG (mmol/L)		1.52 ± 0.27	1.37 ± 0.24	1.7621	0.087
LDL-C (mmol/L)		3.15 ± 0.26	3.02 ± 0.35	1.1631	0.253
Time to ambulation after surgery	< 1 day	6 (37.50)	17 (80.95)	7.2902	0.015
	≥ 1 days	10 (62.50)	4 (19.05)

¹t-test.

²χ² test.

TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol ratio; SII: Systemic immune-inflammation index; TG: Triglycerides; LDL-C: Low-density lipoprotein cholesterol; GI: Gastrointestinal.