Nomogram-based prediction of postoperative seroma in elderly patients undergoing ambulatory hernia repair.

BACKGROUND

This study aimed to explore potential risk factors associated with the occurrence of postoperative seroma in elderly patients after ambulatory hernia surgery and to construct a prediction model.

METHODS

This study consecutively included elderly patients who underwent ambulatory Lichtenstein tension-free hernioplasty for inguinal hernia from 2021 to 2024. The receiver operating characteristic (ROC) curves were used to assess the predictive and optimal cut-off points of continuous variables. Multivariate regression analysis was used to identify independent risk factors. Based on the identified factors, a nomogram model was further constructed and evaluated using R.

RESULTS

A total of 340 patients were enrolled in this study, and 35 cases (10.3 ​%) developed seroma within three months post-surgery. Body mass index (BMI) ​≥ ​24.0 (OR: 2.65, 95 ​%CI: 1.15-6.14, P ​= ​0.023), taking anticoagulant drug (OR: 3.04, 95 ​%CI: 1.31-7.03, P ​= ​0.009),systemic immune-inflammation index (SII) ​≥ ​892.5 (OR: 8.34, 95 ​%CI: 3.44-20.21, P ​< ​0.001), and prognostic nutritional index (PNI) ​< ​50.4 (OR: 5.54, 95 ​%CI: 1.87-16.41, P ​= ​0.002) were four independent risk factors for seroma by the logistic regression analysis. The AUC of the nomogram based on these four indicators was 0.848, with a sensitivity of 0.751 and a specificity of 0.829. The external validation from another center indicated that the nomogram model acts well with an AUC of 0.903.

CONCLUSIONS

The nomogram model based on BMI, anticoagulant drug use, SII, and PNI possesses well predictive capabilities for postoperative seroma after ambulatory hernia surgery.