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Published on: December 18, 2010
Glasgow prognostic score is a practical predictive index for postoperative intra-abdominal septic complications after
Yibin Zhu1, Haili Xu1, Wei Liu1
1Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou, 310016, People's Republic of China.
Insights
The Glasgow Prognostic Score (GPS) can predict postoperative septic complications in Crohn's disease (CD) patients undergoing bowel resection. A higher preoperative GPS indicates increased risk, necessitating perioperative optimization for better outcomes.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Inflammatory Bowel Disease Research
Background:
- Postoperative intra-abdominal septic complications (IASCs) are a significant concern in Crohn's disease (CD) patients following surgery.
- Identifying reliable predictors for IASCs is crucial for improving patient outcomes after elective bowel resection in CD.
Purpose of the Study:
- To evaluate the predictive value of the inflammation-based Glasgow Prognostic Score (GPS) for postoperative IASCs in patients with CD.
- To determine if GPS can serve as an index for identifying CD patients at higher risk of IASCs after elective intestinal resection.
Main Methods:
- Retrospective analysis of 163 CD patients who underwent elective intestinal resection.
- Patients were stratified into lower and higher GPS groups based on serum C-reactive protein and albumin levels.
- Univariate and multivariate analyses were performed to identify risk factors for postoperative IASCs.
Main Results:
- IASCs occurred in 15.3% of patients, with a significantly higher incidence in the higher GPS group (38.71% vs. 9.85%, P < 0.001).
- Higher GPS was associated with longer postoperative hospital stays (15.71 ± 9.17 vs. 10.53 ± 7.00 days, P = 0.001).
- Preoperative GPS (OR 5.016) and penetrating disease behavior (OR 4.495) were identified as independent risk factors for IASCs.
Conclusions:
- The preoperative Glasgow Prognostic Score is a valuable tool for predicting postoperative IASCs in CD patients undergoing bowel resection.
- Patients with a higher GPS require perioperative optimization to mitigate the risk of IASCs and improve surgical outcomes.
Purpose:
Postoperative intra-abdominal septic complications (IASCs) are not uncommon in patients with Crohn's disease (CD). The appropriate index to predict postoperative IASCs in these individuals remains unknown. This study investigates whether the inflammation-based Glasgow prognostic score (GPS) is predictive in the setting of postoperative IASC CD patients who underwent elective bowel resection.
Methods:
A consecutive cohort of 163 CD patients who underwent elective intestinal resection from July 2012 to March 2016 was retrospectively analyzed. Patients were divided into two GPS groups, one lower and one higher. The GPS was defined by serum levels of C-reactive protein and albumin. Univariate and multivariate analyses were conducted to identify risk factors for postoperative IASCs.
Results:
Postoperative IASCs occurred in 25 (15.3%) patients. Compared with patients in the lower GPS group, patients with a higher GPS had a higher incidence of postoperative IASCs (9.85 vs. 38.71%, P < 0.001) and experienced longer postoperative hospital stay (10.53 ± 7.00 vs. 15.71 ± 9.17, P = 0.001). Univariate and multivariate analyses revealed preoperative GPS [odds ratio (OR) 5.016, 95% confidence interval (CI) 1.134-22.193, P = 0.034] and penetrating behavior (OR 4.495, 95% CI 1.377-14.670, P = 0.013) to be independent risk factors for postoperative IASCs.
Conclusions:
A preoperative GPS can serve as a useful index for predicting manifestation of postoperative IASCs after bowel resection in patients with CD. Perioperative optimization is required to improve postoperative outcomes for patients with higher GPS.
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