Abstract
This study aimed to investigate application of Onodera prognostic nutrition index (OPNI) and neutrophil-to-lymphocyte ratio (NLR) in evaluating risk of postoperative complications in Crohn’s disease (CD). Clinical data of 108 postoperative CD patients in 9 years were respectively reviewed. OPNI and NLR were within 1 week preoperatively. Average OPNI was 38.8 ± 8.2 and significantly lower in patients with: CD type B3; lymphopenia; decreased haemoglobin, prealbumin, and albumin; and daily enteral nutrition <500 kcal/d. Average NLR was 5.9 ± 12.1 and significantly higher in patients with: CD type B3, neutrophilia, lymphopenia, decreased prealbumin, and enteral nutrition <500 kcal/d. Youden index was maximal at OPNI 39.8 and NLR 4.1, patients were divided into two groups by OPNI 39.8 and NLR 4.1; Low OPNI (≤39.8) group had significantly greater incidence of type B3, lymphopenia, decreased haemoglobin, prealbumin and albumin, and enteral nutrition <500 kcal/day, more likely to have intra-abdominal bleeding. High NLR group (≥4.1) had significantly greater incidence of type B3, neutrophilia, and lymphopenia, more likely to develop lung infection. OPNI and NLR were significantly negatively correlated. Smoking within 1 year preoperatively, OPNI <39.8, NLR ≥ 4.1 were independent risk factors for postoperative complications in CD.
Highlights
The Onodera prognostic nutrition index (OPNI), established by Onodera after the analysis of 200 gastrointestinal surgery patients in 1984, is an index used to evaluate the nutritional condition and predict surgical risk of gastrointestinal surgery patients[1, 2]
Distribution of OPNI and neutrophil-to-lymphocyte ratio (NLR) According to Clinical Features
The distribution of OPNI and NLR according to clinical features, such as sex, age, smoking history, blood type, primary lesion location, disease type, and preoperative body mass index (BMI) are shown in Tables 1 and 2
Summary
The Onodera prognostic nutrition index (OPNI), established by Onodera after the analysis of 200 gastrointestinal surgery patients in 1984, is an index used to evaluate the nutritional condition and predict surgical risk of gastrointestinal surgery patients[1, 2]. Many studies have investigated the relationship between the OPNI and gastrointestinal diseases[3, 4] Another parameter used for prognostic evaluation in gastrointestinal diseases is the neutrophil-to-lymphocyte ratio (NLR), which is an index used to measure the severity of systemic inflammation[5, 6]. Crohn’s disease (CD) is an inflammatory gastrointestinal disease that can cause systemic inflammation and severe malnutrition, which influences prognosis and postoperative recovery.
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