The Usefulness of Nutritional Index CONUT for Risk Assessment and Prognosis after Pancreaticoduodenectomy

Abstract

Rationale: Pancreaticoduodenectomy (PD) is a highly invasive surgery. Therefore, assessment of pre-operative nutritional status may contribute to the postoperative course. Method(s): Patients (n = 116) who had undergone PD were included in this study. We evaluated the usefulness of the body mass index (BMI), prognostic nutrition index (PNI), and controlling nutritional status score (CONUT) for evaluating post-operative complication risk by examining the relationship between pre-operative nutritional status and the occurrence of post-operative complications such as surgical site infection (SSI) and remote infection (RI). Result(s): Eighty-nine of 116 patients (76.7%) developed postoperative complications. Of the 89 patients, who developed complications, SSI and RI occurred in 38 (32.8%) and 23 (19.8%) patients, respectively. Logistic regression revealed the association between the CONUT score and survival in univariate analysis (p = 0.012). BMI was also associated with survival in univariate analysis (p = 0.020). Patients in the high CONUTsore and BMI < 18.5 group, had poorer prognosis compared with Low CONUT score group. Conclusion(s): CONUT is a simple and useful marker for identifying patients at increased risk for predicting long-term survival after highly invasive surgery such as PD. Based on our results; we suggest that CONUT should be included in the routine assessment of patients undergoing highly invasive surgery.