Predictive value of malnutrition universal screening tool and prognostic nutritional index on postoperative complications and prognosis of patients with pancreatic cancer
Objective To explore the predictive value of malnutrition universal screening tool(MUST)and prognos-tic nutritional index(PNI)on postoperative complications and prognosis of patients with pancreatic cancer.Method A total of 103 patients with primary pancreatic cancer were selected,and their nutritional status were evaluated by MUST and PNI before surgery.The clinical characteristics and laboratory indicators of pancreatic cancer patients with different nutritional status were compared.The influencing factors of postoperative malnutrition in patients with pancreatic cancer were analyzed by multivariate Logistic regression.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive value of MUST score and PNI single and combined detection on the complications of patients with pancreatic cancer after surgery were evaluated.The Kaplan-Meier method was used to plot survival curves,and the survival was compared by using Log-rank test.Result The preoperative nutritional as-sessment results showed that among 103 patients,68 cases had MUST score≥ 1 point,and 35 cases had MUST score＜1 point;70 cases had PNI≥45,and 33 cases had PNI＜45.There were statistically significant differences in age,combined basic diseases,differentiation degree,postoperative complications,and hospital stay in pancreatic cancer patients with dif-ferent MUST scores and PNI(P＜0.05).Before operation,the levels of albumin and lymphocytes in pancreatic cancer pa-tients with different MUST scores and PNI were significantly different(P＜0.05).Multivariate Logistic regression analysis showed that age＞55 years was an independent risk factor for postoperative MUST score≥ 1 point and PNI＜45 in pancreat-ic cancer patients(P＜0.05),poor differentiation was an independent protective factor for postoperative PNI＜45 in pancre-atic cancer patients(P＜0.05).The ROC curve showed that the AUC for predicting postoperative complications in patients with pancreatic cancer by MUST score and PNI single and combined detection were both 0.785.The 1-year survival rate of pancreatic cancer patients with MUST score＜1 point was 88.24％,which was higher than 37.14％of patients with MUST score≥ 1 point(P＜0.01),the 1-year survival rate of pancreatic cancer patients with PNI≥45 was 87.14％,which was significantly higher than 42.42％of patients with PNI＜45(P＜0.01).Conclusion MUST score and PNI can reflect the occurrence of complications and survival of patients with pancreatic cancer after surgery to a certain extent.Accord-ing to the preoperative nutritional status assessment results,giving corresponding intervention measures may be of great significance to improve the nutritional status and prognosis of patients.
万方数据
维普
