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437 The value of prognostic nutritional index in determining gynecologic oncology patients at risk of developing infectious morbidity: an interim analysis
  1. V Pergialiotis,
  2. T Papalios,
  3. DE Vlachos,
  4. C Theofanakis,
  5. V Theodoulidis,
  6. N Thomakos,
  7. A Rodolakis and
  8. D Haidopoulos
  1. National and Kapodistrian University of Athens, First department of Obstetrics and Gynecology, Athens, Greece


Introduction/Background*The nutritional adequacy of patients undergoing major surgery is an important prognostic indicator of survival. Studies in other surgical subspecialties highlight the importance of the nutritional status during the perioperative period of patients undergoing surgery for oncological purposes. In the present interim analysis, we aim to evaluate differences in the values of the prognostic nutritional index among gynecologic oncology patients that develop postoperative infectious morbidity and those that have an uneventful postoperative hospitalization.

Methodology The study is based on a prospective series of patients who underwent surgery for gynecological malignancies. The PNI index was calculated on the basis of admission data as follows: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count (per mm(3)). Data on postoperative infections were retrieved and analyzed with SPSS (IBM Corp. Released 2019.).

Result(s)*Overall 100 patients were followed-up for a period of 30 days postoperatively. Of those 26 patients developed postoperative infectious morbidity. Preoperative PNI was significantly lower among patients that developed infections compared to those that had uneventful recovery (43.0 (12.7-59.1) vs 50,1 (8.1-140.0). Using multiple logistic regression that took into account co-factors of age, BMI, ECOG status, preoperative Hgb, smoking, transfusion rates, implementation of ERAS protocol and PNI we observed that the latter was a significant moderator of post-operative infectious morbidity (HR 0.924, 95% CI 0.876, 0.974). Receiver operative characteristics (ROC) analysis revealed that PNI had a moderate value in determining postoperative infectious morbidity (AUC 0.782, Sensitivity 77%, Specificity 68% using an optimal cut-off of 45.4).

Conclusion*Taking into consideration the results of this interim analysis we believe that PNI could be a valuable tool in clinical practice that may help determine patients at risk of developing postoperative morbidity. Future studies may also use this index as a prognostic factor that could indicate the nutritional status of patients undergoing prehabilitation in anticipation of major surgical operations.

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