Glasgow prognostic score is a practical predictive index for postoperative intra-abdominal septic complications after bowel resection in Crohn’s disease patients
- 82 Downloads
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.
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.
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.
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.
KeywordsCrohn’s disease Glasgow prognostic score Postoperative complications Bowel resection Penetrating disease
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).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
- 8.Morar PS, Hodgkinson JD, Thalayasingam S, Koysombat K, Purcell M, Hart AL, Warusavitarne J, Faiz O (2015) Determining predictors for intra-abdominal septic complications following ileocolonic resection for Crohn’s disease-considerations in pre-operative and peri-operative optimisation techniques to improve outcome. J Crohns Colitis 9(6):483–491CrossRefPubMedGoogle Scholar
- 10.Zhang M, Gao X, Chen Y, Zhi M, Chen H, Tang J, Su M, Yao J, Yang Q, Chen J, Hu P, Liu H (2015) Body mass index is a marker of nutrition preparation sufficiency before surgery for Crohn's disease from the perspective of intra-abdominal septic complications: a retrospective cohort study. Medicine (Baltimore) 94(35):e1455CrossRefGoogle Scholar
- 26.Heerasing N, Thompson B, Hendy P, Heap GA, Walker G, Bethune R, Mansfield S, Calvert C, Kennedy NA, Ahmad T, Goodhand JR (2017) Exclusive enteral nutrition provides an effective bridge to safer interval elective surgery for adults with Crohn’s disease. Aliment Pharmacol Ther 45(5):660–669CrossRefPubMedGoogle Scholar
- 37.Nasir BS, Dozois EJ, Cima RR, Pemberton JH, Wolff BG, Sandborn WJ, Loftus EV, Larson DW (2010) Perioperative anti-tumor necrosis factor therapy does not increase the rate of early postoperative complications in Crohn's disease. J Gastrointest Surg 14(12):1859–1865 1865-1866CrossRefPubMedGoogle Scholar
- 42.Kunitake H, Hodin R, Shellito PC, Sands BE, Korzenik J, Bordeianou L (2008) Perioperative treatment with infliximab in patients with Crohn’s disease and ulcerative colitis is not associated with an increased rate of postoperative complications. J Gastrointest Surg 12(10):1730–1736, 1736-1737CrossRefPubMedGoogle Scholar