Prognostic Nutritional Index Predicts Short-term Post-operative Outcomes After Surgery For Crohn’s Disease

Objective:Surgery is required in majority of patients with Crohn’s disease (CD) during their lifetime. The prognostic nutritional index (PNI) is a useful tool for predicting short-term and long-term post-operative outcomes in patients undergoing cancer surgery. However, few studies have investigated PNI in CD surgery. We examined the ability of PNI to predict short-term outcomes in patients with CD.Methods:From January2012to December2014,73patients who underwent bowel resection for CD were prospectively enrolled in the study. The PNI was calculated on the basis of admission data, according to the following formula:10*albumin (g/dl)+0.005*total lymphocyte count (per mm3). The mean age was36.14years. Over half the cohorts were men (n=46,63.0%). Patients were divided in two groups:PNI<40comprised30patients; PNI≥40comprised43patients. Clinical and laboratory parameters were compared between the two groups.Results:Significant difference was found in BMI (17.9±2.4vs.19.2±2.2, p<0.05) between the two groups. Post-operative overall and infectious complications occurred in15(50.0%) and14(46.7%) patients in group with PNI<40versus10(23.3%) and7(16.3%) in group with PNI≥40respectively, which were both statistically significant (p <0.05). However, there was no significant difference of post-operative hospital stay between the groups (p=0.138). In univariable logistic regression analysis, BMI<18.5, penetrating behavior, open surgery, and PNI<40were associated with an increased risk of overall complications and infectious complications. In multivariate analysis, only PNI<40was an independent prognostic factor for infectious complications:odds ratio (OR):3.846,95%confidence interval (1.145-12.821).Conclusions:Pre-operative PNI is a useful predictor of post-operative infectious complications in patients with CD.