Abo-Ryia Mohammad Hamdy, Abd Elwahab Ahmed Taher, Saber Sherif Abel-Fatah, Elgarf Sherif Mohamed
Department of general surgery, faculty of medicine, Tanta University, Tanta, Egypt.
Eur J Trauma Emerg Surg. 2025 Aug 11;51(1):272. doi: 10.1007/s00068-025-02943-2.
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.
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.
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%.
The three nutritional assessment scores were significant predictors of postoperative complications in emergency abdominal surgery, with the NRI showing the highest diagnostic accuracy.
各种营养评估分数已得到验证，并被接受作为择期手术术后结局的预测指标。本研究的目的是前瞻性评估其中三种分数（CONUT分数、PNI和NRI）对急诊腹部手术后短期结局的预测价值。
这是一项为期13个月的前瞻性队列研究。该研究获得了当地伦理委员会的批准，纳入了150例行急诊腹部大手术且同意参与研究的患者。所有纳入患者均进行了临床评估，并根据其临床表现接受了实验室和影像学检查。收集了计算三种营养指数所需的数据。患者接受了特定手术，并根据手术类型按照标准方案在外科重症监护病房或外科病房接受术后护理。
男性占研究人群的64.70%，平均年龄为48.48±15.80岁，平均体重指数为29.55±4.99kg/m²。50.7%的患者术前诊断为各种病因引起的腹膜炎，而21.3%的患者被诊断为肠梗阻。根据CONUT分数，43.3%的患者术前营养状况正常，46%为轻度营养不良，10.7%为中度营养不良，无重度营养不良患者。PNI值范围为32.4至59.5，平均为46.76±6.55，而NRI值范围为33.8至49.9，平均为46.94±1.90。NRI的诊断准确性最高，为73%，其次是CONUT分数，为68%，最后是PNI，为66%。
这三种营养评估分数是急诊腹部手术后术后并发症的重要预测指标，其中NRI的诊断准确性最高。
