RÉSUMÉ
Background:Nutritional status and inflammatory indicators in patients with gastrointestinal tumors have a significant impact on patient prognosis.Aims:To investigate the association between preoperative nutritional/inflammation-related indicators and the prognosis of colorectal cancer patients underwent radical surgery,and to identify valuable prognostic assessment indicators.Methods:Colorectal cancer patients underwent radical surgery from 2018 to 2020 were enrolled,and a patient cohort was established.Clinical data were collected,correlation of preoperative nutritional/inflammation-related indicators with prognosis were analyzed,and predictive nutritional/inflammation-related indicators were screened.Results:A total of 146 patients were collected in this study.The results of Cox proportional risk model univariate analysis showed that family history of tumor,TNM staging,CEA,AGR,PLR,and SII were significantly associated with survival(P<0.05).Multivariate analysis revealed that preoperative AGR(HR=0.227,95%CI:0.087-0.595;P=0.003),NLR(HR=2.472,95%CI:1.058-5.778;P=0.037),PLR(HR=2.692,95%CI:1.162-6.235;P=0.021)and SII(HR=5.237,95%CI:1.857-14.771;P=0.002)were associated with prognosis of colorectal cancer patients,and AGR had the best prognostic ability.Conclusions:Four preoperative nutritional/inflammatory indicators,AGR,NLR,PLR,and SII,are associated with prognosis of colorectal cancer patients underwent radical surgery.
RÉSUMÉ
Background:At present,domestic guidelines and consensus recommend the use of nutritional risk screening 2002(NRS 2002)and patient-generated subjective global assessment(PG-SGA)for nutritional risk screening and assessment of patients with gastrointestinal cancer during the perioperative period.However,PG-SGA has higher professional requirements,complex content and time-consuming.In the current busy situation of medical staff,NRS 2002 is more used for screening alone.Aims:To explore the consistency of NRS 2002 and PG-SGA in the assessment of nutritional status and clinical outcomes in patients with gastrointestinal malignancies,and to explore the accuracy of screening using NRS 2002 alone,so as to provide guidance for the establishment of clinical nutritional screening and assessment standards.Methods:A retrospective analysis was conducted on 157 patients with gastrointestinal malignancies who underwent radical operation in the Department of Gastrointestinal Surgery of Xiangya Hospital,Central South University from January 2020 to October 2022.Nutritional screening and evaluation were performed by NRS 2002 and PG-SGA scales and demographic data and nutrition-related laboratory indicators were collected to observe short-term postoperative clinical outcomes.Results:Patients with nutritional risk or malnutrition had lower body mass index(BMI),lymphocytes and prealbumin(P<0.05).The correlation and consistency of NRS 2002 and PG-SGA scales were good(r=0.728,κ=0.46)and the areas under the curve(AUC)for predicting postoperative complications were 0.691 and 0.702,respectively.In addition,nutritional risk and postoperative complications were significantly increased in patients with malnutrition(P<0.05).Conclusions:Therefore,gastrointestinal surgeons can only use NRS2002 to perform nutritional screening of patients and make corresponding nutritional treatment according to the screening results in the case of busy clinical work.