Prospective Assessment of the Prognostic Value of Different Nutritional Assessment Scores on Short-term Outcome after Emergency Colorectal Surgery

Abstract

Background: Pre-operative nutritional state has a direct impact on complications following surgery and the prognosis of individuals with malignant tumors. It has been shown that enhancing perioperative nutrition may save costs while also improving clinical outcomes for patients having major gastrointestinal surgeries. As a result, individuals having significant abdominal surgery should have careful evaluation to their nutritional condition. So, accurate scoring method to detect patients with inadequate nutritional status has been looked for by several studies. The controlling nutritional status (CONUT) scoring, the nutrition risk index (NRI) and the prognosis nutritional index (PNI) are some of them. The objective of this research was to prospectively assess the prognostic effect of the PNI, the CONUT score and the NRI on postoperative wound problems following urgent colorectal cancer procedures. Patients and Methods: This prospective research was conducted between November 2020 and June 2022 at Tanta University's emergency department, general surgery department, and gastrointestinal surgery unit. The research comprised thirty individuals who were hospitalized for emergency colorectal cancer procedures. We calculated the three scores (CONUT, PNI and NRI) after measuring the pre-operative blood albumin level, total peripheral lymphocyte number and serum cholesterol, and compared them to the post-operative result. Results: Based on CONUT score: 38.89% patients had normal nutrition, 47.22% had light malnutrition, 13.89% had moderate malnutrition with a cut-off value 4.The mean value of NRI is 45.9 ± 2.95, and cut off value is 46.1. The mean value of PNI is 46.3 ± 5.68 and cut off value is 45.23. Conclusion: This study revealed significant relation between PNI blew a cut-off value 45.2, low CONUT score blew a cut-off value 4, low NRI blew a cut-off value 46.1, and the development of postoperative complication after urgent surgeries for colorectal cancer with a diagnostic accuracy of 72%, 67% and 65%, respectively. PNI is superior to CONUT and NRI in predicting postoperative complications in urgent surgeries for colorectal cancer.