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- Title
Worse Preoperative Status Based on Inflammation and Host Immunity Is a Risk Factor for Surgical Site Infections in Colorectal Cancer Surgery.
- Authors
Masano Sagawa; Kazuhiko Yoshimatsu; Hajime Yokomizo; Yuki Yano; Sachiyo Okayama; Takebumi Usui; Kentaro Yamaguchi; Shunichi Shiozawa; Takeshi Shimakawa; Takao Katsube; Hiroyuki Kato; Yoshihiko Naritaka
- Abstract
Objective: The modified Glasgow Prognostic Score (mGPS) is an inflammation-based measure of malnutrition that reflects a state of cachexia in cancer patients. We evaluated mGPS as an index to predict surgical site infection (SSI) incidence in patients undergoing colorectal cancer surgery. Subjects and Methods: We retrospectively analyzed 351 patients who underwent colon cancer resection. Factors correlated with the incidence of SSIs were identified by logistic analysis and stepwise selection. Results: SSIs were observed in 32 patients, with an incidence of 9.1%. Univariate logistic analysis revealed mGPS (Score 2), laparotomy, resection of other organs, colostomy, excessive blood loss (>423 mL), long duration of surgery (>279 minutes), pulmonary dysfunction, prognostic nutritional index (PNI) ≤40, neutrophil lymphocyte ratio (NLR)(>4), and controlling nutritional status (CONUT) ≥2 to be associated with an increased incidence of SSIs. Multivariate analysis with variables selected by the stepwise procedure also revealed mGPS (Score 2) (Odds ratio (OR)=3.55, 95% Confidence interval (CI) 1.30-9.56; p=0.01), colostomy (OR=6.56, 95%CI 1.60-31.38; p=0.01), excessive blood loss (OR=3.20, 95%CI 1.23-8.42; p=0.02), and NLR (>4)(OR=3.24, 95%CI 1.31-8.17; p=0.01) to be independent risk factors. Conclusion: mGPS is an independent risk factor for SSIs. Our results suggest that cachexia before surgery in patients with colorectal cancer might predict the incidence of SSIs.
- Subjects
PREOPERATIVE care; COLON cancer patients; SURGICAL site; INFECTION risk factors; INFLAMMATION; CACHEXIA; DIAGNOSIS
- Publication
Journal of Nippon Medical School, 2017, Vol 84, Issue 5, p224
- ISSN
1345-4676
- Publication type
Article
- DOI
10.1272/jnms.84.224