.: ORİJİNAL ARAŞTIRMA
Prognostik Nutrisyonel İndeksin Radikal Sistektomi ve İleal Kondüit Sonrası Komplikasyonları Öngörmedeki Değeri: Retrospektif Klinik Çalışma
Value of Prognostic Nutritional Index on Complications After Radical Cystectomy and Ileal Conduit: Retrospective Clinical Research
J Reconstr Urol. 2022;12(1):16-21
doi: 10.5336/urology.2021-87848
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: Prognostic nutritional index (PNI) is a method that can be easily calculated according to the serum albumin level and lymphocyte count and shows the nutritional and immune status of patients. PNI was originally developed as an indicator of the preoperative nutritional status of patients with gastrointestinal malignancies. The aim of this study is to evaluate the value of PNI in prediction of postoperative complications after radical cystectomy and ileal conduit. Material and Methods: We conducted a retrospective study of patients who underwent radical cystectomy and ileal conduit between 2011 and 2021. A total of 174 patients were included in this study. The patients were divided into 2 groups according to the cutoff value of the PNI: those with a PNI≥46 (normal group) and those with a PNI<46 (low PNI group). The clinicopathological features between the 2 groups were compared using the χ2 test. Results: A total of 174 radical cystectomy with ileal conduit patients were available for analysis. The cohort included 140 males and 34 females. Overall, 36 (20.6%) patients encountered a Grade ≥ III complication after surgery. In the normal group, 9 (17.5%) of patients had Grade ≥ III complication and 27 of patients (34.04%) in low PNI group had Grade ≥ III complication after surgery. When the groups were compared in terms of major complication rates, there were statistically significant more Grade ≥ III complications in the low PNI group (p<0.001). Conclusion: PNI can be used clinically to predict the possibility of serious postoperative complications in patients who are candidates for radical cystectomy.
Keywords: Urinary diversion; cystectomy; nutrition assessment; complications
Objective: Prognostic nutritional index (PNI) is a method that can be easily calculated according to the serum albumin level and lymphocyte count and shows the nutritional and immune status of patients. PNI was originally developed as an indicator of the preoperative nutritional status of patients with gastrointestinal malignancies. The aim of this study is to evaluate the value of PNI in prediction of postoperative complications after radical cystectomy and ileal conduit. Material and Methods: We conducted a retrospective study of patients who underwent radical cystectomy and ileal conduit between 2011 and 2021. A total of 174 patients were included in this study. The patients were divided into 2 groups according to the cutoff value of the PNI: those with a PNI≥46 (normal group) and those with a PNI<46 (low PNI group). The clinicopathological features between the 2 groups were compared using the χ2 test. Results: A total of 174 radical cystectomy with ileal conduit patients were available for analysis. The cohort included 140 males and 34 females. Overall, 36 (20.6%) patients encountered a Grade ≥ III complication after surgery. In the normal group, 9 (17.5%) of patients had Grade ≥ III complication and 27 of patients (34.04%) in low PNI group had Grade ≥ III complication after surgery. When the groups were compared in terms of major complication rates, there were statistically significant more Grade ≥ III complications in the low PNI group (p<0.001). Conclusion: PNI can be used clinically to predict the possibility of serious postoperative complications in patients who are candidates for radical cystectomy.
Keywords: Urinary diversion; cystectomy; nutrition assessment; complications
ÖZET
Amaç: Prognostik nutrisyonel indeks (PNİ), serum albumin düzeyi ve lenfosit sayısına göre kolaylıkla hesaplanabilen, hastaların beslenme ve bağışıklık durumunu gösteren bir yöntemdir. PNİ ilk olarak gastrointestinal kanserli hastaların ameliyat öncesi beslenme durumunun bir göstergesi olarak geliştirilmiştir. Bu çalışmanın amacı, kasa invaze mesane kanseri nedeniyle radikal sistektomi ve ileal kondüit uygulanan hastalarda PNİ'nin postoperatif komplikasyonları öngörmedeki değerini araştırmaktır. Gereç ve Yöntemler: 2011-2021 yılları arasında radikal sistektomi ve ileal kondüit uygulanan hastaları retrospektif olarak değerlendirdik. Bu çalışmaya toplam 174 hasta dâhil edildi. Hastalar PNİ eşik değerine göre PNİ≥46 olanlar (normal grup) ve PNİ<46 olanlar (düşük PNİ grubu) olmak üzere 2 gruba ayrıldı. İki grup arasındaki klinikopatolojik özellikler χ2 testi kullanılarak karşılaştırıldı. Bulgular: Toplam 174 radikal sistektomi ve ileal kondüit yapılan hasta analize uygundu. Kohort, 14 erkek ve 34 kadın hastadan oluşuyordu. Ameliyat sonrası 36 (%20,6) hastada Grade ≥ III komplikasyonla karşılaşıldı. Normal grupta 9 (%17,5) hastada cerrahi sonrası Grade ≥ III komplikasyon ile karşılaşılırken, düşük PNİ grupta 27 (%34,04) hastada Grade ≥ III komplikasyon görüldü. Gruplar majör komplikasyon oranları açısından karşılaştırıldığında, düşük PNİ grupta istatistiksel olarak anlamlı derecede daha fazla Grade ≥ III komplikasyon görüldü (p<0,001). Sonuç: PNİ, radikal sistektomi adayı hastalarda ciddi postoperatif komplikasyonları öngörmek için klinik olarak kullanılabilir.
Anahtar Kelimeler: Üriner diversiyon; sistektomi; beslenme değerlendirmesi; komplikasyonlar
Amaç: Prognostik nutrisyonel indeks (PNİ), serum albumin düzeyi ve lenfosit sayısına göre kolaylıkla hesaplanabilen, hastaların beslenme ve bağışıklık durumunu gösteren bir yöntemdir. PNİ ilk olarak gastrointestinal kanserli hastaların ameliyat öncesi beslenme durumunun bir göstergesi olarak geliştirilmiştir. Bu çalışmanın amacı, kasa invaze mesane kanseri nedeniyle radikal sistektomi ve ileal kondüit uygulanan hastalarda PNİ'nin postoperatif komplikasyonları öngörmedeki değerini araştırmaktır. Gereç ve Yöntemler: 2011-2021 yılları arasında radikal sistektomi ve ileal kondüit uygulanan hastaları retrospektif olarak değerlendirdik. Bu çalışmaya toplam 174 hasta dâhil edildi. Hastalar PNİ eşik değerine göre PNİ≥46 olanlar (normal grup) ve PNİ<46 olanlar (düşük PNİ grubu) olmak üzere 2 gruba ayrıldı. İki grup arasındaki klinikopatolojik özellikler χ2 testi kullanılarak karşılaştırıldı. Bulgular: Toplam 174 radikal sistektomi ve ileal kondüit yapılan hasta analize uygundu. Kohort, 14 erkek ve 34 kadın hastadan oluşuyordu. Ameliyat sonrası 36 (%20,6) hastada Grade ≥ III komplikasyonla karşılaşıldı. Normal grupta 9 (%17,5) hastada cerrahi sonrası Grade ≥ III komplikasyon ile karşılaşılırken, düşük PNİ grupta 27 (%34,04) hastada Grade ≥ III komplikasyon görüldü. Gruplar majör komplikasyon oranları açısından karşılaştırıldığında, düşük PNİ grupta istatistiksel olarak anlamlı derecede daha fazla Grade ≥ III komplikasyon görüldü (p<0,001). Sonuç: PNİ, radikal sistektomi adayı hastalarda ciddi postoperatif komplikasyonları öngörmek için klinik olarak kullanılabilir.
Anahtar Kelimeler: Üriner diversiyon; sistektomi; beslenme değerlendirmesi; komplikasyonlar
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