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Glasgow prognostic score is a practical predictive index for postoperative intra-abdominal septic complications after bowel resection in Crohn’s disease patients

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Postoperative intra-abdominal septic complications (IASCs) are not uncommon in patients with Crohn’s disease (CD). The appropriate index to predict postoperative IASCs in these individuals remains unknown. This study investigates whether the inflammation-based Glasgow prognostic score (GPS) is predictive in the setting of postoperative IASC CD patients who underwent elective bowel resection.

Methods

A consecutive cohort of 163 CD patients who underwent elective intestinal resection from July 2012 to March 2016 was retrospectively analyzed. Patients were divided into two GPS groups, one lower and one higher. The GPS was defined by serum levels of C-reactive protein and albumin. Univariate and multivariate analyses were conducted to identify risk factors for postoperative IASCs.

Results

Postoperative IASCs occurred in 25 (15.3%) patients. Compared with patients in the lower GPS group, patients with a higher GPS had a higher incidence of postoperative IASCs (9.85 vs. 38.71%, P < 0.001) and experienced longer postoperative hospital stay (10.53 ± 7.00 vs. 15.71 ± 9.17, P = 0.001). Univariate and multivariate analyses revealed preoperative GPS [odds ratio (OR) 5.016, 95% confidence interval (CI) 1.134–22.193, P = 0.034] and penetrating behavior (OR 4.495, 95% CI 1.377–14.670, P = 0.013) to be independent risk factors for postoperative IASCs.

Conclusions

A preoperative GPS can serve as a useful index for predicting manifestation of postoperative IASCs after bowel resection in patients with CD. Perioperative optimization is required to improve postoperative outcomes for patients with higher GPS.

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Funding

This study was supported by the Zhejiang Provincial Natural Science Foundation of China under Grant No. LY18H030006 and the Jie-Shou Li’s Special Foundation for intestinal mucous barrier (award number LJS-201603).

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Authors and Affiliations

  1. Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, People’s Republic of China

    Yibin Zhu, Haili Xu, Wei Liu, Weilin Qi, Xiaoyan Yang & Wei Zhou

  2. Inflammatory Bowel Disease Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China

    Lingna Ye, Qian Cao & Wei Zhou

  3. Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China

    Lingna Ye & Qian Cao

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  1. Yibin Zhu
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Correspondence to Wei Zhou.

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Zhu, Y., Xu, H., Liu, W. et al. Glasgow prognostic score is a practical predictive index for postoperative intra-abdominal septic complications after bowel resection in Crohn’s disease patients. Int J Colorectal Dis 33, 947–953 (2018). https://doi.org/10.1007/s00384-018-3035-5

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