Worse Preoperative Status Based on Inflammation and Host Immunity Is a Risk Factor for Surgical Site Infections in Colorectal Cancer Surgery

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%CI1.23 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. (J Nippon Med Sch 2017; 84: 224 230)

Impact of Abdominal Aortic Calcification Among Liver Transplantation Recipients

“…In the present study, the AAC level had a close relationship with the GPS and mGPS, and this level reflects the systemic inflammatory response. The systemic inflammatory response may be worse because of malnutrition and reduced preoperative immunocompetence, suggesting that compromised immunocompetence may influence infections . The GPS was also reported as the better predictive system in patients with HCC after living donor LT in our population .…”

“…The systemic inflammatory response may be worse because of malnutrition and reduced preoperative immunocompetence, suggesting that compromised immunocompetence may influence infections. (15,16) The GPS was also reported as the better predictive system in patients with HCC after living donor LT in our population. (17) Therefore, the finding that a high AAC level leads to poorer survival and a high systemic inflammatory response is highly compelling.…”

Controlling Nutritional Status (CONUT) Score is Associated with Overall Survival in Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Cohort Study

“…The CONUT score is also associated with poor survival in patients with hepatitis B virus reactivation [19]. In addition, it has been reported to predict the prognosis of patients with various cancers, including gastric cancer, colon cancer, and pancreatic cancer [20][21][22].…”

Pulmonary Dysfunction Function and Poor Nutritional Status are Risk Factors for Remote Infections Following Surgery for Colorectal Cancer

“…We analyzed clinicopathological factors associated with RI, as categorized in a previous report 5 . We also calculated prognostic nutritional index (PNI) 6 , neutrophil lymphocyte ratio (NLR) 7 , and controlling nutritional status (CONUT) 8 , and mGPS, as previously reported.…”

“…Infectious complications are classified into surgical site infections (SSIs) and remote infections (RIs), which differ in pathogenesis 4 . We previously reported that cachexia is an independent risk factor for SSI using mGPS as an index 5 . However, among infectious complications, whether or not cachexia affects only SSI remains inconclusive 4 .…”