Prognostic nutritional index associates with the prognoses of colorectal cancer with acute bowel perforation after primary resection and anastomosis
Objective To explore the correlation between preoperative prognostic nutritional index(PNI)with postoperative complications and survival of colorectal cancer(CRC)patients with acute bowel perforation(ABP).Methods From December 2012 to June 2018,the relevant clinical data were retrospectively reviewed for 57 CRC patients with ABP undergoing curative resection and primary anastomosis.The clinicopathological profiles,nutritional status,postoperative complications,5-year overall survival(OS)and recurrence-free survival(RFS)were recorded.The cut-off value of preoperative PNI was calculated by receiver operating characteristic(ROC)curve.The association of PNI with postoperative complications was examined by Logistic regression.And 5-year OS/RFS was analyzed by Kaplan-Meier method.Results The optimal cut-off value of PNI was 32.PNI-low group had more elders(P=0.0285),more ASA grade Ⅲ-Ⅳ(P=0.0147)and more T4 stage(P=0.0281)as compared with PNI-high group.Moreover,low PNI was associated with greater anastomotic leakage(P=0.031 4),higher 30-day mortality(P=0.030 3)and prolonged hospitalization stay(P=0.024 2).Further multivariate analysis indicated that low PNI was a risk factor of anastomotic leakage(OR=1.63,95%CI:1.56-3.82,P=0.030 8).However,PNI was not associated with 5-year OS/RFS in CRC patients with ABP.Conclusion In CRC patients with ABP,preoperative low PNI(<32)is a clinical predictor of anastomotic leakage,greater 30-day mortality and longer hospitalization stay after primary resection and anastomosis.
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