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-Original-
Pulmonary Dysfunction Function and Poor Nutritional Status are Risk Factors for Remote Infections Following Surgery for Colorectal Cancer
1Department of Surgery, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
2Department of Clinical Laboratory, Tokyo Women's Medical University Medical Center East, Tokyo, Japan
Objective: We evaluated the preoperative patient status including nutrition, immunity, and inflammation as a predictive factor of remote infection (RI) in colorectal cancer surgery.
Subjects and Methods: A total of 351 patients who underwent colorectal cancer resection were retrospectively analyzed. Factors correlated with RI incidence were identified by logistic analysis and stepwise selection.
Results: RI occurred in 27 patients, with an incidence of 7.7%. In univariate logistic analysis, a significantly high incidence of RI was associated with excessive blood loss (>423 mL), long duration of surgery (>279 minutes), ileus, pulmonary dysfunction, performance status (PS)≥1, American Society of Anesthesiologists (ASA) classification>2, prognostic nutritional index (PNI)≤40, and controlling nutritional status (CONUT)≥2, modified Glasgow Prognostic Score (mGPS) (Score 2).In multivariate analysis, pulmonary dysfunction (odds ratio=2.83; 95% CI: 1.14-6.97; p=0.02) and PNI≤40 (odds ratio=3.87; 95% CI: 1.45-10.31; p=0.006) were independent risk factors of RI incidence.
Conclusion: RI is caused by poor nutrition, immune system dysfunction and pulmonary dysfunction.
J Nippon Med Sch 2018; 85: 208-214
Keywords
remote infection (RI), colorectal cancer surgery, pulmonary dysfunction, prognostic nutritional index (PNI), modified Glasgow Prognostic Score (mGPS)
Correspondence to
Kazuhiko Yoshimatsu, MD, PhD, Department of Surgery, Tokyo Women's Medical University Medical Center East, Nishiogu 2-1-10, Arakawa-ku, Tokyo 116-8567, Japan
kyoshsu@twmu.ac.jp
Received, January 30, 2018
Accepted, March 1, 2018
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