Analysis of the Incidence and Risk Factors Influencing Postoperative Complications in Patients with Gynecological...

Perioperative patient complications are a global concern for patient safety. Few studies have systematically evaluated the factors associated with complications during the perioperative period of gynecologic malignancies from a nursing or caregiving perspective. Therefore, this study aimed to investigate the incidence and risk factors of postoperative complications in patients with gynecological malignancies from a holistic care perspective.

This retrospective study included 3,372 patients from the information system of a university-affiliated teaching hospital in China, with data collected from October 1, 2018, to September 30, 2023. A nomogram was constructed based on the predictive factors. Its goodness-of-fit was examined using the Hosmer-Lemeshow test, and calibration curves were used for internal evaluation. The clinical utility of the nomogram was quantified using clinical decision curve analysis.

The incidence of postoperative complications in patients with gynecological malignancies was 13.0%. Nomograms constructed based on employment status, intraoperative warming, blood and fluid loss, cancer type, and cancer stage were bootstrap-corrected with a consistency index of .63. The calibration curves showed good agreement between predicted and actual probabilities. The net benefit of screening all patients based on the nomogram was greater than no screening when the risk of complications was 5.0-30.0%.

Gynecological malignancies are associated with a high incidence of postoperative complications. Employment status, intraoperative warming, bleeding and rehydration fluid, cancer type, and cancer stage are independent risk factors for these complications, and their incidence can be predicted using the nomogram. The results of this study highlight the important role of nursing strategies in preventing complications. These findings have important implications for clinical nursing intervention and decision-making.