Nomogram to predict postoperative complications after surgical resection in adult patients with carotid body tumors.

Background

Surgical resection remains the primary treatment for carotid body tumors (CBTs), but it carries a considerable risk of postoperative complications. Although several predictors have been identified, no validated tool currently exists to estimate the individualized risk of complications in CBT patients. This study aimed to develop a nomogram for predicting postoperative complications following CBT resection.

Methods

We retrospectively analyzed adult patients who underwent surgical resection for CBTs at our institution between 2016 and 2022. Potential predictors of postoperative complications, including stroke and cranial nerve injury, were evaluated using multivariate logistic regression. A nomogram was then constructed and internally validated using bootstrap resampling and 10-fold cross-validation. Model discrimination, calibration, and clinical utility were assessed by the area under the receiver operating characteristic curve, calibration plots, and decision curve analysis.

Results

A total of 230 patients (240 tumors) were included. Postoperative complications occurred in 38.3% of tumors, including 9 strokes and 83 cranial nerve injuries. The final nomogram incorporated the Shamblin classification, prior cerebral ischemia, and white blood cell count as independent predictors, achieving an AUC of 0.72 with a cutoff value of 94.6 for predicting postoperative complications.

Conclusions

The proposed nomogram demonstrated good discriminative ability and calibration for predicting postoperative complications after CBT surgery. It may assist clinicians in identifying high-risk patients and optimizing perioperative management strategies. Further external validation across diverse populations is warranted to confirm its generalizability.