Morikawa Keisuke, Takemura Hiroyuki, Kitayama Kana, Inaba Shogo, Imaoka Haruka, Hashitsume Yu, Suzuki Yuta, Tabira Kazuyuki
Department of Rehabilitation, Matsusaka Municipal Hospital, Matsusaka, Japan.
Graduate School of Health Sciences, Kio University, Kitakatsuragi, Japan.
JMA J. 2025 Jul 15;8(3):825-831. doi: 10.31662/jmaj.2025-0017. Epub 2025 Jun 27.
Several studies have reported an association between postoperative complications and nutritional indices. Among these, serum prealbumin (PAB) levels have recently attracted attention as an indicator of nutritional status. However, the nutritional index most strongly associated with postoperative complications remains unclear. This study aimed to investigate the relationship between postoperative complications and nutrition-related indices, including PAB, in patients who underwent surgery for gastric cancer.
A total of 108 patients who underwent gastric cancer surgery were classified into 2 groups based on the presence or absence of postoperative complications. PAB, serum albumin (ALB), Controlling Nutritional Status (CONUT) score, and Prognostic Nutritional Index (PNI) were used as preoperative nutrition-related indices. The relationship between postoperative complications and nutrition-related indices was examined using multivariate logistic regression analyses.
Among the participants, 84 were classified into the uncomplicated group and 24 into the complicated group. Multivariate logistic regression analysis revealed significant associations between all nutrition-related indices and postoperative complications, including PAB (odds ratio [OR], 0.808; 95% confidence interval [CI]: 0.716-0.911, p = 0.001), CONUT score (OR, 1.338; 95% CI: 1.095-1.635, p = 0.004), ALB (OR: 0.364, 95% CI: 0.157-0.845, p = 0.019), and PNI (OR: 0.931, 95% CI: 0.870-0.997, p = 0.042). Among these, PAB showed the strongest association, followed by CONUT, ALB, and PNI.
All nutritional indicators were associated with postoperative complications. Our findings suggest that PAB and CONUT scores may serve as useful predictors of postoperative complications in patients with gastric cancer.
多项研究报告了术后并发症与营养指标之间的关联。其中，血清前白蛋白（PAB）水平作为营养状况指标最近受到关注。然而，与术后并发症关联最密切的营养指标仍不明确。本研究旨在调查接受胃癌手术患者的术后并发症与包括PAB在内的营养相关指标之间的关系。
总共108例接受胃癌手术的患者根据术后并发症的有无分为两组。术前营养相关指标采用PAB、血清白蛋白（ALB）、控制营养状况（CONUT）评分和预后营养指数（PNI）。采用多因素逻辑回归分析检查术后并发症与营养相关指标之间的关系。
参与者中，84例被分为无并发症组，24例被分为并发症组。多因素逻辑回归分析显示所有营养相关指标与术后并发症之间均存在显著关联，包括PAB（比值比[OR]，0.808；95%置信区间[CI]：0.716 - 0.911，p = 0.001）、CONUT评分（OR，1.338；95% CI：1.095 - 1.635，p = 0.004）、ALB（OR：0.364，95% CI：0.157 - 0.845，p = 0.019）和PNI（OR：0.931，95% CI：0.870 - 0.997，p = 0.042）。其中，PAB显示出最强的关联，其次是CONUT、ALB和PNI。
所有营养指标均与术后并发症相关。我们的研究结果表明，PAB和CONUT评分可能是胃癌患者术后并发症的有用预测指标。
