Objective To investigate the risk factors for inflammatory complications after radical gastrectomy for gastric cancer and construct a nomogram model for risk prediction.

Methods The clinical data of 402 patients with primary gastric cancer who underwent radical gastrectomy were retrospectively analyzed. All patients underwent preoperative Nutritional Risk Screening 2002 (NRS2002) score, Patient-Generated Subjective Global Assessment (PG-SGA) grading, Lumbar 3 Skeletal Muscle Index (L3-SMI) assessment, and serological index testing. Univariate analysis was used to screen for influencing factors of postoperative inflammatory complications of gastric cancer, and multivariate Logistic regression analysis was conducted to determine independent risk factors. A nomogram model for predicting postoperative inflammatory complications after radical gastrectomy was constructed based on the results of multivariate Logistic regression analysis, and the predictive performance of the model was evaluated using the receiver operating characteristic (ROC) curve and calibration curve.

Results Univariate analysis revealed that age, TNM stage, body mass index, preoperative hemoglobin, preoperative albumin, preoperative globulin, NRS2002 score, PG-SGA grade, and L3-SMI were influencing factors of postoperative inflammatory complications in patients undergoing radical gastrectomy (P < 0.05). Multivariate Logistic regression analysis showed that age ≤60 years, preoperative hemoglobin ≤130 g/L(male) or ≤115 g/L(female), TNM staging of Ⅳ stage, NRS2002 score≥3, and L3-SMI ≤52.4 cm²/m²(male) or ≤38.5 cm²/m²(female) were independent risk factors for postoperative inflammatory complications in gastric cancer patients (P < 0.05). A nomogram model was constructed based on age, preoperative hemoglobin, TNM stage, and NRS2002 score. The ROC curve showed that the area under the curve of the nomogram model was 0.930, with sensitivity and specificity of 93.2% and 89.2%, respectively. The calibration curve demonstrated good consistency between the predicted probability of inflammatory complications and the actual outcomes.

Conclusion Age≤60 years, low preoperative hemoglobin, TNM staging of Ⅳ stage, NRS2002 score ≥3, and low L3-SMI are independent risk factors for postoperative inflammatory complications in gastric cancer patients. The nomogram model constructed based on age, preoperative hemoglobin, TNM stage, and NRS2002 score can accurately predict postoperative inflammatory complications after gastrectomy for gastric cancer.