Abstract
Systemic Inflammation-Based modified Glasgow Prognostic Score (mGPS) was developed as an objective tool to grade state of inflammation. However, the association between mGPS and postoperative complications for inflammatory bowel disease (IBD) patients was still unknown. In our study, 270 IBD patients [Crohn’s disease (CD), n = 186; Ulcerative colitis (UC), n = 84] from January 2013 and January 2016 who underwent elective bowel resection were retrospectively analyzed, and, the levels of preoperative C-reactive protein (CRP) and albumin were included as parameters of mGPS. The incidence of overall postoperative complications was 44.81% (121/270), including 46.77% (87/186) of CD and 40.48% (34/84) of UC. According to multivariate analysis, mGPS (CD: OR = 3.47, p = 0.003; UC: OR = 3.28, p = 0.019) was independently associated with an increased risk of postoperative complications. Patients with a higher mGPS also suffered longer postoperative stay and increased SSIs (both p < 0.05). Combining mGPS with neutrophil ratio improved its prognostic value with a better area under the curve (AUC), using receiver operating characteristic (ROC) method. Then we confirmed that mGPS was associated with postoperative complications in IBD patients undergoing elective bowel resection and the addition of neutrophil ratio enhanced its prognostic value.
Highlights
Patients suffered from inflammatory bowel disease (IBD) are mainly young adults without significant comorbidities[1,2,3], the incidence of postoperative complication is higher than other gastrointestinal benign diseases, which may be caused by long-term consumption, inflammatory activity, chronic infection and drug-related adverse effects
MGPS has been used in other diseases like systemic lupus erythematosus (SLE) and acute decompensated heart failure (ADHF)[17,18]
It provides more prognostic information in terms of the severity and prognosis for malignant tumor compared to the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), which have been widely used in IBD19–21
Summary
Patients suffered from inflammatory bowel disease (IBD) are mainly young adults without significant comorbidities[1,2,3], the incidence of postoperative complication is higher than other gastrointestinal benign diseases, which may be caused by long-term consumption, inflammatory activity, chronic infection and drug-related adverse effects. For Crohn’s disease (CD), low level of preoperative nutritional indicators such as body mass index (BMI), hemoglobin and albumin are independent risk factors of postoperative complications[8,9,10]. Abscess or fistula at the time of laparotomy increases the risk of postoperative complications of CD patients[13]. MGPS has been used in other diseases like systemic lupus erythematosus (SLE) and acute decompensated heart failure (ADHF)[17,18]. It provides more prognostic information in terms of the severity and prognosis for malignant tumor compared to the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), which have been widely used in IBD19–21. We aim to optimize the mGPS to enhance its prognostic value for IBD patients
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