Predictive Value Of NRS2002 And MNA On Postoperative Omplications In Patients With Hepatic Alveolar Echinococcosis

Objective:To explore the predictive value of NRS2002 and MNA in postoperative complications of patients with hepatic alveolar echinococcosis.Methods:patients hospitalized for HAE and treated with surgery(radical resection and ablation)from 2019 to 2021 were selected.NRS2002 and MNA were used to evaluate the patients.The preoperative information(BMI,total bilirubin,PNM stage of hepatic alveolar echinococcosis,etc.)and postoperative complications were obtained according to the hospital patient management system(Clavien-Dindo grade≥Ⅱ was defined as postoperative complications).Univariate and multivariate analysis was carried out according to the grouping of complications.The relationship between postoperative complications,nutritional support and MNA and NRS2002 nutritional evaluation methods,and the consistency of the two nutritional evaluation methods were discussed.The accuracy of predicting postoperative complications in patients with hepatic alveolar echinococcosis was evaluated by the slope area under the working curve of the subjects.The two nutritional evaluation methods were combined by logistic regression,and the combined indexes MNA and NRS2002 were compared The value of NRS2002 in predicting postoperative complications.Results:1.ALB,weight,MNA and BMI in the complication group were significantly lower than those in the non complication group;NRS2002,operation time,intraoperative bleeding,radical hepatectomy,PNM stagesⅢ and Ⅳ and child-Pugh grade B were significantly higher than those in the non complication group.There was no significant difference in gender,age,height,nutritional support,total bilirubin and AST(P>0.05).PNM stage,operation time and nrs2002,and the regression coefficient is positive,which are independent risk factors.2.For the consistency analysis of the two,it can be concluded that the consistency of MNA and NRS2002 is general(kappa=0.462,P<0.05).3.Patients with nutritional risk and malnutrition identified by MNA and NRS2002 had a higher incidence of postoperative complications(P<0.05).4.Patients with high nutritional support rate,For NRS2002,the complication rate of nutritional support group was lower(P<0.05).5.According to the subject working curve of predicting postoperative complications of HAE patients through NRS2002 and MNA,the slope area under the curve is 0.843(95%CI,0.762～0.924)and 0.787(95%CI=0.693～0.882)respectively.Logistic regression combines MNA and nrs2002 and extracts the equation as 0.872 × NRS2002-0.113 ×mna-0.657,and the slope area under the curve is 0.851(95%CI=0.769～0.932).Conclusion:1.The rate of postsurgical complication is higher in HAE patients with poor preoperative trophic state.2.NRS2002 and MNA can judge the nutritional status of patients with hepatic alveolar echinococcosis,but the consistency in judging the nutritional status of patients is general.The simple use of MNA and nrs2002 can lead to missed judgment of nutritional status of patients with HAE.3.NRS2002 and MNA are valuable in predicting postoperative complications.Combining the two nutritional evaluation methods can more accurately predict the occurrence of postoperative complications in patients with hepatic alveolar echinococcosis.