Clinical Value of NLR MAGE and PNI on Predicting Intra-Abdominal Infection after Anatomical Hepatectomy
CHEN Jianyu, ZHONG Yang, LIU Zhi, et al
The Second Department of Hepatobiliary Surgery / The Affiliated Hospital of North Sichuan Medical College/Hepatobiliary,Pancreatic and Intestinal Institute, North Sichuan Medical College, Sichuan Nanchong 637001,China
Abstract：Objective: To explore the clinical value of the neutrophil-to-lymphocyte ratio (NLR), mean amplitude of glycemic excursions (MAGE), and prognostic nutritional index (PNI) in predicting the intra-abdominal infection after anatomical hepatectomy. Methods: 192 patients who underwent anatomical hepatectomy in the hospital were selected between October 2018 and October 2021, including 43 patients with postoperative intra-abdominal infection (infected group) and 149 patients without intra-abdominal infection (non-infected group). All patients received routine blood examination and blood glucose monitoring within 3 d before surgery. The NLR, MAGE, and PNI were calculated and the differences between groups were analyzed. The receiver operating characteristic curve (ROC curve) was used to evaluate the value of the three indicators for predicting the postoperative intra-abdominal infection. Results: There were statistical differences between the infection group and the non-infected group in terms of the presence of diabetes mellitus, surgical time, and indwelling time of the intra-abdominal drainage tube (P<0.05). NLR, MAGE, and PNI in the infected group before surgery were significantly higher than those in the non-infected group (P<0.05). The areas under the ROC curves of NLR and MAGEPNI for predicting intra-abdominal infection after anatomical hepatectomy were 0.825 (95%CI:0.763~0.876), 0.957 (95%CI:0.918~0.981) and 0.914 (95%CI:0.865~0.949) respectively, with good predictive efficiency. Logistics regression analysis showed that the presence of diabetes mellitus, surgical time≥ 5h, drainage tube indwelling time≥3d, NLR>2.35, MAGE>0.83, and PNI>43.79 were the risk factors for intra-abdominal infection after anatomical hepatectomy (P<0.05). Conclusion: Preoperative NLR, MAGE, and PNI have certain predictive value on postoperative intra-abdominal infection in patients with anatomical hepatectomy, and can provide a reference for clinical prevention and treatment.
2022, Vol. 28 
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