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Immune-nutritional indicators predict short-term mortality in older patients after emergency gastrointestinal
Zechuan Jin1, Tinghan Yang1, Ziqiang Wang2
1Colorectal Cancer Center, Department of General Surgery, West China Hospital, Sichuan University, Guo Xue Xiang No. 37, Chengdu, 610041, China.
Background:
The aim of this study was to discover immune-nutritional indicators that can preoperatively predict short-term mortality in older patients undergoing emergency gastrointestinal surgery.
Methods:
We retrospectively analyzed older patients older than 65 years of age who underwent various types of emergency gastrointestinal surgery under general anesthesia between January 2012 and December 2023. The immune-nutritional indicators were defined according to previous literature. The primary endpoint of this study was 90-day survival after surgery.
Results:
A total of 4120 patients older than 65 years were included in this study. ROC curves and the decision curve analysis for eight factors predicting 90-day postoperative survival were well predicted by the mGPS (0.68, 95% CI: 0.66-0.70), PNI (0.68, 95% CI: 0.66-0.71) and CONUT score (0.68, 95% CI: 0.66-0.70). The models constructed by LASSO Cox and CoxBoost were used to score the risk for each patient, and the high LASSO Cox model risk score group had worse 90-day survival than the low score group, whereas patients in the low CoxBoost model score group had a worse prognosis. The AUC of the CoxBoost model was greater than that of the LASSO Cox model. A nomogram model was constructed using the variables screened by the LASSO Cox model with a C-index of 0.706.
Conclusions:
Immune-nutritional factors could be a favorable predictor for older patients undergoing emergency gastrointestinal surgery.
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