The Preliminary Study Of The Possibility Of NRS2002 On The Nutrition Estimate Of The Disease Of Hilar Cholangiocarcinoma

Objective: To investigate the possibility of NRS2002 in preoperative nutritional assessment of hilar cholangiocarcinoma by analyzing the relationship between preoperative NRS2002 scores and postoperative complications and its diagnostic value for postoperative complications.Methods: From January 2002 to December 2015, clinical data of 82 patients with hilar cholangiocarcinoma who underwent surgery in Shanxi Provincial People’s Hospital were collected. According to the nutritional risk screening 2002(NRS2002), the clinic date of 82 cases with hilar cholangiocarcinoma were divided into two groups named having nutritional risk(score≥3) and well nutrition(score<3), and its relationship with the postoperative complications were analyzed by chi square test. According to the postoperative complications, the clinic date were divided into postoperative complications group and none postoperative complications group, and the relationship between preoperative NRS2002 scores and postoperative complications was analyzed by logistic regression analysis. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the ROC curve of the preoperative NRS2002 scores which served as diagnostic criteria were calculated compared with the results with the "gold standard" of postoperative complications, and by which the value of NRS2002 scores in the diagnosis of postoperative complications were evaluated.Results: According to NRS2002, there were 42 cases(51.2%) in having nutritional risk group and 40 cases(48.8%) in well nutrition group. The overall postoperative complications(c2=7.395,P=0.007), infective complications(c2=7.045,P=0.008) and non serious complications(c2=4.306,P=0.038) were associated with the preoperative NRS2002 scores. Logistic regression analysis showed that the preoperative NRS2002 scores(unadjusted OR=7.200, 95%CI: 2.651~19.558, adjusted OR=4.122, 95%CI: 1.258~13.508), before and after adjusting for preoperative BMI, preoperative nutritional support, preoperative biliary drainage, serum albumin index, CA19-9 index of carbohydrate antigen, operation method and operation time, were risk factor for postoperative complications. Using the preoperative NRS2002 scores as diagnostic standard to diagnose whether or not have postoperative complications, the sensitivity and specificity were 73.3% and 75.0%,with accuracy 74.5%, positive predictive value 57.9%, negative predictive value 85.7% and area under the ROC curve 0.745.Conclusion: Preoperative NRS2002 scores is an independent risk factor for postoperative complications in patients with hilar cholangiocarcinoma and it has a certain value in the diagnosis of having postoperative complications. NRS2002 can be used as a effective method for evaluating the nutritional status of patients with hilar cholangiocarcinoma and nutrition support treatment should be given to patients with nutritional risk to reduce the morbidity of postoperative complications and improve prognosis.