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Validation and optimization of the Systemic Inflammation-Based modified Glasgow Prognostic Score in predicting
Chenyan Zhao1, Chao Ding1,2, Tingbin Xie1
1Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Abstract:
Systemic Inflammation-Based modified Glasgow Prognostic Score (mGPS) was developed as an objective tool to grade state of inflammation. However, the association between mGPS and postoperative complications for inflammatory bowel disease (IBD) patients was still unknown. In our study, 270 IBD patients [Crohn's disease (CD), n = 186; Ulcerative colitis (UC), n = 84] from January 2013 and January 2016 who underwent elective bowel resection were retrospectively analyzed, and, the levels of preoperative C-reactive protein (CRP) and albumin were included as parameters of mGPS. The incidence of overall postoperative complications was 44.81% (121/270), including 46.77% (87/186) of CD and 40.48% (34/84) of UC. According to multivariate analysis, mGPS (CD: OR = 3.47, p = 0.003; UC: OR = 3.28, p = 0.019) was independently associated with an increased risk of postoperative complications. Patients with a higher mGPS also suffered longer postoperative stay and increased SSIs (both p < 0.05). Combining mGPS with neutrophil ratio improved its prognostic value with a better area under the curve (AUC), using receiver operating characteristic (ROC) method. Then we confirmed that mGPS was associated with postoperative complications in IBD patients undergoing elective bowel resection and the addition of neutrophil ratio enhanced its prognostic value.
Insights
The modified Glasgow Prognostic Score (mGPS) predicts postoperative complications in inflammatory bowel disease (IBD) patients undergoing surgery. Higher mGPS scores correlate with increased risks and longer hospital stays, with neutrophil ratio improving prediction accuracy.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Inflammatory Bowel Disease Research
Background:
- The modified Glasgow Prognostic Score (mGPS) assesses systemic inflammation.
- The prognostic value of mGPS for postoperative complications in inflammatory bowel disease (IBD) patients remains unclear.
- Elective bowel resection is a common surgical procedure for IBD patients.
Purpose of the Study:
- To investigate the association between mGPS and postoperative complications in IBD patients undergoing elective bowel resection.
- To evaluate the predictive performance of mGPS for complications such as surgical site infections (SSIs) and prolonged hospital stay.
- To determine if combining mGPS with neutrophil ratio enhances its prognostic value.
Main Methods:
- Retrospective analysis of 270 IBD patients (Crohn's disease and Ulcerative Colitis) who underwent elective bowel resection.
- Preoperative C-reactive protein (CRP) and albumin levels were used to calculate mGPS.
- Multivariate analysis and receiver operating characteristic (ROC) curve analysis were employed to assess the association and prognostic value.
Main Results:
- Overall postoperative complication rate was 44.81%.
- mGPS was independently associated with an increased risk of postoperative complications in both CD (OR=3.47, p=0.003) and UC (OR=3.28, p=0.019) patients.
- Higher mGPS correlated with longer postoperative stay and increased SSIs (p<0.05).
- Combining mGPS with neutrophil ratio improved prognostic value (enhanced AUC).
Conclusions:
- mGPS is a significant independent predictor of postoperative complications in IBD patients undergoing elective bowel resection.
- Neutrophil ratio can enhance the prognostic accuracy of mGPS for these patients.
- mGPS serves as a valuable tool for risk stratification and management planning in IBD surgery.
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