Length of Hospital Stay in Patients with Primary Liver Cancer Undergoing Surgery: Risk Factors and Predictive Model Development
Year: 2026
Type: article
Study design: Observational Study
Abstract: Bin Sun,1 Xiaobo Li,2 Xiuying He,1 Na Zhang3 1Department of the International Special Needs Ward, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of China; 2Nursing Department, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of China; 3Department of Hepatobiliary Surgery, First Hospital of China Medical University, Shenyang, Liaoning, 110001, People’s Republic of ChinaCorrespondence: Xiuying He, Email [email protected] Na Zhang, Email [email protected]: To identify preoperative risk factors for prolonged length of hospital stay (LOS) in patients undergoing surgery for primary liver cancer and to develop a predictive nomogram.Methods: We retrospectively analyzed 702 surgical patients from a single center (2020– 2023). LOS was modeled using negative binomial regression based on preoperative factors to construct a nomogram. Model performance was evaluated via internal bootstrap validation (1000 resamples), calibration plots, and decision curve analysis. Prolonged LOS was defined as > 17 days (75th percentile) for a secondary logistic regression analysis.Results: Four independent preoperative factors predicted longer LOS: lower serum cholinesterase, higher fibrinogen, intrahepatic cholangiocarcinoma (vs hepatocellular carcinoma), and female sex (all p< 0.05). The nomogram showed moderate discriminative ability (apparent AUC ~0.67) with good calibration. The mean absolute error for LOS prediction was ~4.6 days. For predicting prolonged LOS (> 17 days), the logistic model achieved an AUC of ~0.67.Conclusion: We developed an internally validated nomogram using routine preoperative data to estimate the risk of extended hospitalization after liver cancer surgery. This tool may help identify high-risk patients for targeted interventions, although its predictive accuracy is modest, and external validation is required before clinical application.Keywords: length of stay, liver cancer, nomogram, nursing, surgery
Institution: First Hospital of China Medical University
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7130500538
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