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Postoperative nutritional risk following bariatric surgery: a comparative evaluation of the Naples Prognostic Score,
Kadem Arslan1, Süleyman Baş1, Mustafa Temizel2
1Department of Internal Medicine. Sancaktepe Sehit Prof. Dr. Tarining and Research Hospital.
Objective:
this study aimed to assess and compare nutritional status in patients undergoing sleeve gastrectomy using the Naples Prognostic Score, PNI, and CONUT indices, with the objective of facilitating early identification of postoperative nutritional risk and guiding optimal follow-up strategies.
Methods:
this study was conducted in morbidly obese patients aged 18-60 years who underwent sleeve gastrectomy. Anthropometric measurements, laboratory parameters, metabolic and inflammatory parameters derived from blood tests, and nutritional indices including the Naples Prognostic Score, PNI, and CONUT were compared between the preoperative period and the sixth postoperative month.
Results:
a total of 131 morbidly obese patients were included in the study. Of these, 78.6 % were female, and the mean age of the cohort was 36.7 ± 9.9 years, with a mean BMI of 44.6 ± 4.1 kg/m². At 6 months postoperatively, inflammatory parameters showed significant decreases in leukocyte counts, CRP, and NLR, whereas LMR increased (all p < 0.001). Transferrin saturation, folate, vitamin B12, and vitamin D levels increased significantly (all p < 0.001). No significant changes were observed in median PNI and CONUT scores between the preoperative period and 6 months postoperatively. In contrast, the median Naples Prognostic Score decreased significantly (p = 0.017), with a corresponding improvement in NPS based risk group distribution (p = 0.009), whereas PNI and CONUT based group distributions remained unchanged.
Conclusion:
at 6 months following sleeve gastrectomy, significant improvements were observed in anthropometric, metabolic, and inflammatory parameters. While PNI and CONUT scores did not change significantly, the Naples Prognostic Score decreased markedly, with a corresponding improvement in risk group distribution.
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