Prediction of Postoperative Pulmonary Complications Using Preoperative Controlling Nutritional Status (CONUT) Score in Patient with Resectable Non-small Cell Lung Cancer (P12-032-19)

Abstract

ObjectivesPostoperative pulmonary complications (PPCs) significantly impact surgical outcome, but the clinical usefulness of various models used to predict PPCs is questionable. The controlling nutritional status (CONUT) score reflects nutritional deficiency and inflammation and is used to predict clinical outcomes in various malignancies. We aimed to investigate the ability of the CONUT score to predict PPCs after lung resection in patients with non-small cell lung cancer (NSCLC). MethodsWe retrospectively reviewed data of 922 patients with NSCLC who underwent complete resection at Severance Hospital in South Korea during January 2016–December 2017. We analyzed the predictability of the CONUT score for PPCs compared with other inflammatory prognostic markers and PPCs risk scoring systems (prognostic nutritional index [PNI], Glasgow prognostic score [GPS], and assessment of respiratory risk in surgical patients in Catalonia [ARISCAT] score) using receiver operating characteristic curves analysis. ResultsOf 922 study subjects, 522 (56.6%) were male; the mean age was 64.2 years. Lobectomy was the most common type of operation (n = 737, 79.9%). Total incidence of PPCs was 8.6% (n = 79). Prolonged air leak (44.3%) was the most common PPC, followed by pneumonia (32.9%) and pneumothorax (11.4%). The proportion of pneumonia was significantly larger in the high CONUT group (P < 0.05). The CONUT consistently had a higher area under curve (AUC) value (0.64) than other prognostic models (PNI: AUC = 0.61, GPS: AUC = 0.57, and ARISCAT: AUC = 0.54). Multivariate analysis identified male sex (odds ratio [OR] = 1.94), low body mass index (OR = 4.57), and high CONUT score (OR = 1.91) as independent PPCs prognostic factors. Kaplan-Meier analysis revealed a significantly higher 1-year mortality rate for the high CONUT group (hazard ratio = 7.97; 95% confidence interval, 1.78–35.59). ConclusionsPreoperative CONUT score is an independent predictor of PPCs and 1-year mortality in patients with NSCLC. Funding SourcesNone.