{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:04:55Z","timestamp":1784696695331,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative complications afflict approximately 40% of patients undergoing colorectal cancer (CRC) surgery and adversely affect long-term oncological outcomes. Reliable perioperative risk stratification tools that are both clinically interpretable and actionable remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective cohort study enrolled 1,013 consecutive patients undergoing elective radical resection for histopathologically confirmed CRC at a single tertiary center. A nine-system composite complication endpoint was defined. Missing data were handled via multiple imputation by chained equations (MICE;\n                      <jats:italic>m<\/jats:italic>\n                      \u202f=\u202f5). Candidate predictors were screened by univariable logistic regression and LASSO regularization; final predictors were entered into multivariable logistic regression with Rubin\u2019s rules pooling. Model performance was assessed by AUC, bootstrap internal validation (1,000 iterations), Hosmer\u2013Lemeshow calibration, and decision curve analysis (DCA). A nomogram was constructed for individualized risk estimation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1,013 patients, 372 (36.7%) experienced \u22651 postoperative complication. LASSO selected eight independent predictors: NRS-2002 nutritional risk score (aOR 1.502, 95% CI 1.312\u20131.720), laparoscopic approach (aOR 0.457, 95% CI 0.297\u20130.702), intraoperative blood loss (aOR 1.002\/mL), right colon tumor location (aOR 1.502), NLR (aOR 1.080\/unit), operative time (aOR 1.002\/min), hemoglobin, and total bilirubin. The model achieved an apparent AUC of 0.689 (bootstrap-corrected 0.680), satisfactory calibration (Hosmer\u2013Lemeshow\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.709), and net clinical benefit across threshold probabilities of 10\u201390% on DCA. Sensitivity analyses confirmed robustness across four pre-specified scenarios (AUC range 0.666\u20130.715).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This LASSO-derived nomogram provides transparent, bedside-applicable risk stratification for postoperative composite complications in CRC surgery, identifying nutritional status as the dominant modifiable predictor and supporting targeted perioperative optimization.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1854727","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:39:36Z","timestamp":1784695176000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Nutritional risk score drives postoperative morbidity in colorectal cancer: findings from a LASSO-selected multivariable model in 1013 consecutive patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Lu","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University","place":["Yinchuan, Ningxia, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University","place":["Yinchuan, Ningxia, China"]},{"name":"Department of Anesthesiology, Clinical Medical College and The First Affiliated Hospital of Chengdu Medical College","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqin","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University","place":["Yinchuan, 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