Patients with Crohn’s disease (CD) are at a high risk of having postoperative complications. Preoperative prognostic nutritional index (PNI) has been extensively studied in terms of postoperative complications in malignancies but seldom in terms of CD.
Patients who underwent CD-related bowel surgery for the first time in our hospital were retrospectively enrolled from January 2013 to October 2019. Differences in clinical features in low- (≤34) and high-PNI (>34) groups were compared. A prognostic nomogram was then established to explore the risk factors and their assignments of postoperative complications.
124 patients who underwent CD-related bowel surgery in our hospital from January 2013 to October 2019 were enrolled. Of these patients, 39 (31.5%) were categorized in the low-PNI group. The serum albumin levels (23.4±4.8 g/L vs 35.8±5.2 g/L, P<0.001), hemoglobin levels (98.0±24.1 vs 115.8±22.2 g/L, P<0.001), and white blood cell levels (8.3±5.4×109 vs 6.3±3.0×109, P=0.009) of the patients in the low-PNI group were lower than those in the high-PNI group. Postoperative complications were observed in 35 cases of the total cohort, 20 out of 39 (51.3%) in the low-PNI group, and 15/85 (17.6%) in the high-PNI group (P<0.001). A prognostic nomogram was built through LASSO regression. The nomogram revealed a significant difference in the length of postoperative stay between patients with high-risk postoperative complications and those with low-risk postoperative complications (17.07±24.73 vs 10.36±4.51, P=0.02).
PNI is closely associated with postoperative complications in CD patients. Its inclusion in a prognostic nomogram provides a convenient mechanism to predict postoperative complications in patients with CD undergoing surgery.