Correlation of Operative Mortality and Morbidity With Preoperative C-Reactive Protein/Albumin Ratio, Neutrophil/Lymphocyte Ratio, and Prognostic Nutritional Index in Patients Undergoing Emergent Operations Due to Strangulation Ileus

IF 0.2 4区 医学 Q4 SURGERY
M. Ikeguchi, T. Hanaki, Kyoichi Kihara, K. Endo, Kazunori Suzuki, Seiichi Nakamura, T. Sawada, Tetsu Shimizu
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引用次数: 2

Abstract

Emergent surgery is necessary in patients with strangulation ileus. However, such procedures are associated with high morbidity and mortality. A retrospective analysis was performed to determine whether the preoperative C-reactive protein/albumin ratio (CAR); neutrophil/lymphocyte ratio (NLR); and prognostic nutritional index (PNI) are good indicators of mortality or morbidity in patients undergoing emergent operations for treatment of strangulation ileus. Emergent surgery was performed for 1698 patients at Tottori Prefectural Central Hospital from 2012 and 2015. Among them, 45 patients (2.7%) were preoperatively diagnosed with strangulation ileus. We evaluated the clinical importance of the preoperative CAR, NLR, and PNI in these patients. We excluded pediatric patients from this study. Postoperative complications developed in 14 of 45 (31.1%) patients. The mean postoperative hospital stay among the 14 patients with postoperative complications was significantly longer than that of the 31 patients without postoperative complications (44.0 versus 11.3 days, respectively; P = 0.006). Three patients died of postoperative complications. The overall operative mortality and morbidity rates were 6.7% and 31.1%, respectively. We found strong correlations of postoperative complications with older age, a longer operation time, and an abnormal preoperative CAR, NLR, and PNI. Not only inflammation, but also a patients' nutritional and immune status appear to be strongly correlated with mortality or morbidity after emergent operations for strangulation ileus. Patients with a high CAR and NLR and low PNI preoperatively must be closely monitored for the occurrence of postoperative complications such as surgical site infections or pulmonary complications.
绞窄性肠梗阻急诊手术患者术前c反应蛋白/白蛋白比值、中性粒细胞/淋巴细胞比值及预后营养指数与手术死亡率和发病率的相关性
绞窄性肠梗阻患者需要紧急手术治疗。然而,这种手术与高发病率和死亡率有关。进行回顾性分析,以确定术前C反应蛋白/白蛋白比率(CAR);中性粒细胞/淋巴细胞比率(NLR);和预后营养指数(PNI)是接受紧急手术治疗绞窄性肠梗阻患者的死亡率或发病率的良好指标。2012年至2015年,鸟取县中央医院为1698名患者进行了紧急手术。其中45例(2.7%)术前诊断为绞窄性肠梗阻。我们评估了这些患者术前CAR、NLR和PNI的临床重要性。我们将儿科患者排除在本研究之外。45例患者中有14例(31.1%)出现术后并发症。14名有术后并发症的患者的平均术后住院时间明显长于31名无术后并发症患者(分别为44.0天和11.3天;P=0.006)。3名患者死于术后并发症。总的手术死亡率和发病率分别为6.7%和31.1%。我们发现术后并发症与年龄较大、手术时间较长以及术前CAR、NLR和PNI异常密切相关。绞窄性肠梗阻紧急手术后,不仅炎症,患者的营养和免疫状况似乎与死亡率或发病率密切相关。术前CAR和NLR高、PNI低的患者必须密切监测术后并发症的发生,如手术部位感染或肺部并发症。
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来源期刊
International surgery
International surgery 医学-外科
CiteScore
0.30
自引率
0.00%
发文量
10
审稿时长
6-12 weeks
期刊介绍: International Surgery is the Official Journal of the International College of Surgeons. International Surgery has been published since 1938 and has an important position in the global scientific and medical publishing field. The Journal publishes only open access manuscripts. Advantages and benefits of open access publishing in International Surgery include: -worldwide internet transmission -prompt peer reviews -timely publishing following peer review approved manuscripts -even more timely worldwide transmissions of unedited peer review approved manuscripts (“online first”) prior to having copy edited manuscripts formally published. Non-approved peer reviewed manuscript authors have the opportunity to update and improve manuscripts prior to again submitting for peer review.
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