Development and validation of a nomogram prediction model for postoperative complications in elderly patients with endometrial cancer

Abstract

Objective: To identify the risk factors associated with postoperative complications in elderly patients with endometrial cancer and to develop a nomogram model for individualized risk assessment.

Methodology: This retrospective study included 150 elderly patients who underwent surgical treatment for endometrial cancer at Baoding No.1 Central Hospital between January 2022 to October 2025. Patients were divided into a complication group(n=46) and a non‐complication group(n=104) based on the occurrence of postoperative complications. Multivariate logistic regression analysis was conducted to identify risk factors. A nomogram model was constructed and validated accordingly.

Results: Postoperative complications occurred in 30.67%(46/150) of patients, while 69.33%(104/150) experienced no complications. Statistically significant differences were observed between the complication and non‐complication groups in age(t= 3.021), body mass index(BMI)(t= 4.653), presence of diabetes(χ²= 6.322), duration of operation(DoO)(t= 5.181), and delayed postoperative ambulation (DPA)(χ² = 5.771) (all p< 0.05). Multivariate analysis identified age (odds ratio[OR] = 3.058), BMI(OR= 2.151), diabetes(OR= 1.865), DoO(OR= 2.677), and DPA(OR= 2.371) as independent risk factors(all p< 0.05). A nomogram incorporating these five variables demonstrated excellent predictive performance, with a sensitivity of 89.64%, a specificity of 77.92%, and an area under the receiver operating characteristic curve(AUC) of 0.887(95% confidence interval: 0.833–0.906), indicating high accuracy and clinical utility.

Conclusion: Age, BMI, diabetes, DoO, and DPA are significant risk factors for postoperative complications in elderly patients with endometrial cancer. The constructed nomogram provides a reliable and practical tool for the early identification of high‐risk patients and may facilitate the development of targeted preventive strategies in clinical practice.