BACKGROUND: Transfer to the ICU is common following non-cardiac surgeries, including radical colorectal cancer (CRC) resection. Understanding the judicious utilization of costly ICU medical resources and supportive postoperative care is crucial. This study aimed to construct and validate a nomogram for predicting the need for mandatory ICU admission immediately following radical CRC resection.
METHODS: Retrospective analysis was conducted on data from 1003 patients who underwent radical or palliative surgery for CRC at Ningxia Medical University General Hospital from August 2020 to April 2022. Patients were randomly assigned to training and validation cohorts in a 7:3 ratio. Independent predictors were identified using the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression in the training cohort to construct the nomogram. An online prediction tool was developed for clinical use. The nomogram\'s calibration and discriminative performance were assessed in both cohorts, and its clinical utility was evaluated through decision curve analysis (DCA).
RESULTS: The final predictive model comprised age (P = 0.003, odds ratio [OR] 3.623, 95% confidence interval [CI] 1.535-8.551); nutritional risk screening 2002 (NRS2002) (P = 0.000, OR 6.129, 95% CI 2.920-12.863); serum albumin (ALB) (P = 0.013, OR 0.921, 95% CI 0.863-0.982); atrial fibrillation (P = 0.000, OR 20.017, 95% CI 4.191-95.609); chronic obstructive pulmonary disease (COPD) (P = 0.009, OR 8.151, 95% CI 1.674-39.676); forced expiratory volume in 1 s / Forced vital capacity (FEV1/FVC) (P = 0.040, OR 0.966, 95% CI 0.935-0.998); and surgical method (P = 0.024, OR 0.425, 95% CI 0.202-0.891). The area under the curve was 0.865, and the consistency index was 0.367. The Hosmer-Lemeshow test indicated excellent model fit (P = 0.367). The calibration curve closely approximated the ideal diagonal line. DCA showed a significant net benefit of the predictive model for postoperative ICU admission.
CONCLUSIONS: Predictors of ICU admission following radical CRC resection include age, preoperative serum albumin level, nutritional risk screening, atrial fibrillation, COPD, FEV1/FVC, and surgical route. The predictive nomogram and online tool support clinical decision-making for postoperative ICU admission in patients undergoing radical CRC surgery.
BACKGROUND: Despite the retrospective nature of this study, we have proactively registered it with the Chinese Clinical Trial Registry. The registration number is ChiCTR2200062210, and the date of registration is 29/07/2022.

This paper uses a neural network model to study the protective effect of dexmedetomidine on the anesthesia recovery period and neurocognitive function in elderly patients undergoing radical resection of colorectal cancer. Eighty-eight patients with colorectal cancer who underwent radical surgery in our hospital from January 2015 to June 2017 were randomly divided into groups: study (43 cases) and control (45 cases). The study group was treated with dexmedetomidine for anesthesia. Patients in the study group were given a slow pumping dose of 1 μg/kg to prepare dexmedetomidine at a dose of 1 μg/kg. The pumping time was >10 minutes, and the dose was 0.3 μg after completion. The loading dose of 0.3 (kg·h) was maintained intraoperatively; the control group was given the same amount of saline infusion by the same infusion method. The study found that the probability of cognitive dysfunction in the study group was significantly lower than that in the control group, and the degree of cognitive dysfunction in the study group was significantly lower than that in the control group (P < 0.05). Therefore in the operation of elderly patients with colorectal cancer radical surgery, dexmedetomidine is used for anesthesia to protect postoperative cognitive function and reduce the incidence of cognitive dysfunction. Extensive promotion and application in the clinic.