The modified Glasgow prognostic score in Crohn's disease-does it predict short-term outcome?

BACKGROUND

The modified Glasgow prognostic score (mGPS) has recently gained increased attention as a prognostic marker for malignant disease survival and postoperative short-term complications. Due to lacking data, the present study was conducted to correlate the mGPS with the postoperative course in patients following surgery for Crohn's disease.

METHODS

We enrolled 341 patients who underwent intestinal resection for symptomatic Crohn's disease at a tertiary referral centre between 2000 and 2014. All relevant data were obtained from the institutional database and individual chart review. Thirty-day morbidity was defined according to the Clavien-Dindo classification.

RESULTS

A total of 79 (23.17%) postoperative complications were identified (grade I and II:  = 54, 15.84%; grade III and IV:  = 23, 6.74%; grade V:  = 2, 0.59%). The mGPS did not show any correlation with an eventful postoperative course following surgery (no complication: median mGPS: 1, range 0-2; complications: median mGPS: 1, range 0-2;  = 0.8521). In addition, the occurrence of an anastomotic leakage was not associated with a higher mGPS ( = 0.8592). Patients with an acute indication for surgery ( = 29, 11.44%) had higher median mGPS (median: 2, range 0-2) in contrast to patients who were operated on electively (median: 1, range 0-2;  = 0.0003). No other correlation between surgical characteristics and mGPS was detected.

CONCLUSIONS

In the present study, we could clearly demonstrate that an acute indication for surgery in symptomatic Crohn's disease is associated with higher mGPS scores. However, the mGPS did not correlate with postoperative complications. Further studies are required to define the prognostic value of mGPS in Crohn's disease patients.