Predictive value of various nutritional assessment scores for Short-term outcomes after emergency abdominal surgery: A prospective cohort study.

BACKGROUND

Various nutritional assessment scores have been validated and accepted as predictors of postoperative outcomes in elective surgery. The objective of this study was to assess prospectively the predictive value of three of these scores (the CONUT score, the PNI, and the NRI) for short term outcomes following emergency abdominal surgery.

PATIENTS AND METHODS

This is a prospective cohort study that was conducted over a period of 13 months. It was approved by the local ethical committee and included 150 patients who underwent emergency major abdominal surgeries and agreed to participate in the study. All patients included were clinically assessed and underwent laboratory and radiological investigations based on their presentation. Data required to calculate the three nutritional indices were collected. Patients underwent their specific surgery and received postoperative care in either the surgical ICU or surgical ward according to standard protocols based on the type of surgery.

RESULTS

Males comprised 64.70% of the study populations with a mean age of 48.48 ± 15.80 years and a mean BMI of 29.55 ± 4.99 kg/m2. The preoperative diagnosis was peritonitis due to various etiologies in 50.7% of patients, while 21.3% were diagnosed with intestinal obstruction. According to the CONUT score, the preoperative nutritional status was normal in 43.3% of patients. mild malnutrition in 46%, moderate malnutrition in 10.7%, and no patients with severe malnutrition. The PNI values ranged from 32.4 to 59.5 with a mean of 46.76 ± 6.55 while the NRI values ranged from 33.8 to 49.9 with a mean of 46.94 ± 1.90. The NRI had the highest diagnostic accuracy at 73%, followed by the CONUT score at 68%, and lastly the PNI at 66%.

CONCLUSION

The three nutritional assessment scores were significant predictors of postoperative complications in emergency abdominal surgery, with the NRI showing the highest diagnostic accuracy.