Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan
Department of Surgery, National Hospital Organization Iwakuni Clinical Center, Yamaguchi, Japan.
In Vivo. 2020 Jul-Aug;34(4):1931-1939. doi: 10.21873/invivo.11990.
Backgound: This study aimed to determine the usefulness of the Controlling Nutritional Status (CONUT) scorescore for predicting postoperative pancreatic fistula (POPF).
Data from 108 consecutive pancreaticoduodenectomy cases performed at the Surgery Department of Iwakuni Clinical Center, from April 2008 to May 2018, were included. Preoperative patient data and postoperative complication data were collected.
Of the 108 patients (male=65; female=43; mean age=70 years), 41 (37.9%) had indication for pancreaticoduodenectomy due to pancreatic carcinoma. Grade B or higher POPF was diagnosed in 32 patients (29.6%). In the multivariate analysis, body mass index ≥22 kg/m [odds ratio (OR)=5.24; p=0.005], CONUT score ≥4 (OR=3.28; p=0.042), non-pancreatic carcinoma (OR=47.17; p=0.001), and a low computed tomographic contrast attenuation value (late/early ratio) (OR=4.39; p=0.029) were independent risk factors for POPF.
Patients with high CONUT score are at high risk for POPF. Preoperative nutritional intervention such as immunonutrition might help reduce the POPF risk in these patients.
本研究旨在确定营养状况控制评分（CONUT）在预测术后胰瘘（POPF）中的作用。
纳入 2008 年 4 月至 2018 年 5 月在岩国临床中心外科进行的 108 例连续胰十二指肠切除术患者的数据。收集了术前患者数据和术后并发症数据。
108 例患者中（男 65 例，女 43 例，平均年龄 70 岁），41 例（37.9%）因胰腺癌行胰十二指肠切除术。32 例（29.6%）诊断为 B 级或更高级别的 POPF。多变量分析显示，体质指数≥22kg/m 2（比值比[OR]=5.24；p=0.005）、CONUT 评分≥4（OR=3.28；p=0.042）、非胰腺癌（OR=47.17；p=0.001）和低 CT 对比衰减值（迟/早比值）（OR=4.39；p=0.029）是 POPF 的独立危险因素。
CONUT 评分高的患者发生 POPF 的风险较高。术前营养干预如免疫营养可能有助于降低这些患者的 POPF 风险。
