LAUSR

BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.