Preoperative body mass index-to-prognostic nutritional index ratio predicts pancreatic fistula after pancreaticoduodenectomy.
Preoperative body mass index-to-prognostic nutritional index ratio predicts pancreatic fistula after pancreaticoduodenectomy.
复制标题
术前体重指数与预后营养指数之比可预测胰十二指肠切除术后胰瘘。
DOI：
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发表时间：
2016
影响因子：
8
通讯作者：
K. Hirata
中科院分区：
文献类型：
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作者：
N. Sato;Toshihisa Tamura;N. Minagawa;K. Hirata
背景
评估或评分术后胰瘘(POPF)的风险可能有助于选择高危患者和个体化患者同意。然而，在日常的临床实践中，并没有简单可靠的POPF术前预测指标。
方法
我们研究了体重指数与预后营养指数(BMI/PNI)的比值作为术前指标预测87例接受胰十二指肠切除术患者发生POPF的价值。
结果
临床(B/C级)POPF总发生率为17%(15/87例)。在术前、术中和术后分析的各种变量中，多因素分析表明，较高的BMI和较低的PNI是POPF的独立预测因素。因此，我们研究了BMI/PNI比率作为POPF的术前预测指标。有POPF的患者体重指数/PNI值显著高于无POPF的患者(0.54vs.0.45，P=0.0007)。受试者工作特征(ROC)曲线分析表明，体重指数/PNI比值有较好的预测POPF(ROC曲线下面积0.781)的能力。以0.5作为临界值，BMI/PNI预测POPF的敏感度、特异度和诊断准确率分别为73%、74%和74%。特别是，当限制在老年(≥75岁)男性患者亚组时，BMI/PNI值的敏感度、特异度和诊断准确率分别为100%、100%和100%。
结论
BMI/PNI比值是预测胰腺十二指肠切除术后POPF发生的一个简单的术前指标。
BACKGROUND
Estimating or scoring the risk of post-operative pancreatic fistula (POPF) may help with selection of high-risk patients and individualized patient consent. However, there are no simple and reliable preoperative predictors of POPF used in daily clinical practice.
METHODS
We investigated the utility of body mass index-to-prognostic nutritional index (BMI/PNI) ratio as a preoperative marker to predict the development of POPF in 87 patients undergoing pancreaticoduodenectomy.
RESULTS
The overall incidence of clinical (grade B/C) POPF was 17% (15 of 87 patients). Among various pre-, intra-, and post-operative variables analyzed, higher BMI and lower PNI were identified as independent predictors for POPF by multivariate analysis. We therefore investigated BMI/PNI ratio as a preoperative predictor for POPF. BMI/PNI ratio was significantly higher in patients with POPF than in those without POPF (0.54 vs. 0.45, P=0.0007). A receiver operating characteristic (ROC) curve analysis demonstrated a fair capability of BMI/PNI ratio to predict the occurrence of POPF (area under the ROC curve 0.781). With a cut-off value of 0.5, the sensitivity, specificity, and diagnostic accuracy of BMI/PNI ratio to predict POPF was 73%, 74%, and 74%, respectively. In particular, when restricted to a subgroup of elderly (≥75 years old) male patients, the sensitivity, specificity, and diagnostic accuracy of BMI/PNI ratio was 100%, 100%, and 100%, respectively.
CONCLUSIONS
The BMI/PNI ratio is a simple preoperative marker to predict the occurrence of POPF after pancreaticoduodenectomy.