Predictive Value Of Preoperative Nutritional Assessment Index For Postoperative Complications Of Esophageal Cancer

Objective: To evaluate the predictive value of BMI,PNI,and GNRI for postoperative complications,and to compare their predictive efficacy,in an attempt to find the best and best preoperative nutritional predictors,and to further explore the independent risk factors for postoperative complications and pulmonary complications in patients with esophageal cancer.Methodes: Retrospective analysis in January 2015 to December 2018 in fujian province set up hospital thoracic esophageal surgery(including traditional open surgery and laparoscopic combined thoracic esophageal cancer radical)in patients with clinical data and preoperative nutritional assessment,according to body mass index(BMI into lower BMI groups(BMI < 22,moderately severe malnutrition,n = 90)and high BMI group(BMI or 22,nutrition,normal or mild malnutrition,n = 83),according to the nutrition prognostic index PNI divided into high PNI group(PNI? 48.25,Nutrition,normal or mild malnutrition,n = 126)and low PNI group(PN < 48.25,moderately severe malnutrition,n = 47),according to the elderly nutrition risk index GNRI divided into low GNRI group(GNRI < 92,moderately severe malnutrition,n = 82)and high GNRI group(GNRI 92 or higher,nutrition,normal or mild malnutrition,n = 91)group,their contrast between groups in postoperative complications,pulmonary complications,anastomotic fistula,chyle fistula,gastrointestinal complications,infection of incision,complications occurred on cardiovascular complications,function of liver and kidney damage,Univariate logistic regression was used to analyze the risk factors of postoperative complications and pulmonary complications in patients with esophageal cancer,and multivariate logistic regression was used to analyze the risk factors of postoperative complications and pulmonary complications in patients with esophageal cancer,and the correlation between postoperative nutrition indexes and complications was fr evaluated.Results: The overall complication rate was significantly higher in the low BMI group than in the high BMI group(P = 0.017).The overall complication rate was significantly higher in the low PNI group than in the high PNI group(P < 0.001).The overall complication rate was significantly higher in the low GNRI group than in the high GNRI group(P<0.001).PNI had the most predictive of postoperative overall complications,pulmonary complications,and cardiovascular complications.Good predictive power,the difference was statistically significant.GRNI was valuable in predicting postoperative overall complications and pulmonary complications.The difference was statistically significant.BMI only had predictive value in predicting postoperative overall complications,and the predictive power was the lowest..Univariate analysis found that the operation time was ?355min(F=10.381,P=0.001),the preoperative serum albumin value was <41.5g/L(F=20.032,P<0.001),and the preoperative lymphocyte count was <1.45x10*9/ L(F=26.643,P=<0.001),preoperative BMI values(F=5.153,P=0.017),preoperative PNI values(F=41.744,P<0.001),preoperative GNRI values(F=18.278,P <0.001),lymph node metastasis(F=3.509,P=0.043)was associated with postoperative overall complication,and univariate analysis included multivariate logistic regression analysis showing preoperative PNI risk(mald?2= 35.684,p<0.001),an independent risk factor for postoperative overall complications.Further exploration of postoperative PNI values in patients with postoperative overall complications and uncomplicated patients found PNI values on day 1 postoperatively(F=4.288,p PNI values(F=24.166,p<0.001)and PNI values at day 7 postoperatively(F=30.90,p<0.001)were statistically significant.For postoperative pulmonary complications,multivariate logistic regression analysis was performed on patients with ?355 min(mald?2=5.708,p=0.017)and PNI<48.25(mald?2=16.471,p=<0.001).Independent risk factors for post-pulmonary complications.Further investigation of the postoperative PNI values of patients with postoperative pulmonary complications and patients without pulmonary complications found PNI values on the 3rd day after surgery(F=16.553.,p<0.001),and PNI values on the 7th day after surgery(F =20.928,p < 0.001),the difference was statistically significant.Conclusion: Compared with BMI and GNRI,PNI has better predictive value in postoperative complications.Preoperative PNI risk is an important independent risk factor for postoperative complications and postoperative pulmonary complications.Postoperative PNI values are still associated with postoperative complications.PNI has certain guiding significance for the prediction and management of perioperative complications in patients.