Preoperative Controlling Nutritional Status Score Predicts Mortality after Hepatectomy for Hepatocellular Carcinoma

Kosei Takagi, Yuzo Umeda, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Takuro Fushimi, Toshiyoshi Fujiwara, Takahito Yagi

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6 Citations (Scopus)

Abstract

Background: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. Methods: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015. Patients were divided into 2 groups based on their CONUT score and the PNI. We evaluated the effect of the CONUT score and PNI on perioperative outcomes. Multivariate analysis was performed to identify independent predictors of in-hospital mortality after hepatectomy. ­Results: The high CONUT group had a significantly higher ­incidence of 30-day mortality (p < 0.001), in-hospital mortality (p = 0.002), ascites (p = 0.006), liver failure (p = 0.02), sepsis (p = 0.01), and enteritis (p < 0.001). The low PNI group was also significantly associated with 30-day mortality (p < 0.001), in-hospital mortality (p = 0.003), liver failure (p < 0.001), sepsis (p = 0.02), enteritis (p = 0.02), and hospital stay (p = 0.01). In multivariate analyses, a high CONUT score was an independent predictor of in-hospital mortality after hepatectomy (hazard ratio [HR] 9.41, p = 0.038), but the PNI was not (HR 5.86, p = 0.08). Conclusions: Preoperative assessment of the CONUT score is helpful for evaluating patients’ nutritional status and mortality risk after liver surgery.

Original languageEnglish
JournalDigestive Surgery
DOIs
Publication statusAccepted/In press - Apr 19 2018

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Hepatectomy
Nutritional Status
Hepatocellular Carcinoma
Nutrition Assessment
Mortality
Hospital Mortality
Enteritis
Liver Failure
Sepsis
Multivariate Analysis
Ascites
Length of Stay
Liver
Incidence

Keywords

  • Complications
  • Hepatocellular cancer
  • Liver surgery
  • Mortality
  • Nutrition

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

@article{02de85dda610419ea9b02195ae9f0689,
title = "Preoperative Controlling Nutritional Status Score Predicts Mortality after Hepatectomy for Hepatocellular Carcinoma",
abstract = "Background: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. Methods: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015. Patients were divided into 2 groups based on their CONUT score and the PNI. We evaluated the effect of the CONUT score and PNI on perioperative outcomes. Multivariate analysis was performed to identify independent predictors of in-hospital mortality after hepatectomy. ­Results: The high CONUT group had a significantly higher ­incidence of 30-day mortality (p < 0.001), in-hospital mortality (p = 0.002), ascites (p = 0.006), liver failure (p = 0.02), sepsis (p = 0.01), and enteritis (p < 0.001). The low PNI group was also significantly associated with 30-day mortality (p < 0.001), in-hospital mortality (p = 0.003), liver failure (p < 0.001), sepsis (p = 0.02), enteritis (p = 0.02), and hospital stay (p = 0.01). In multivariate analyses, a high CONUT score was an independent predictor of in-hospital mortality after hepatectomy (hazard ratio [HR] 9.41, p = 0.038), but the PNI was not (HR 5.86, p = 0.08). Conclusions: Preoperative assessment of the CONUT score is helpful for evaluating patients’ nutritional status and mortality risk after liver surgery.",
keywords = "Complications, Hepatocellular cancer, Liver surgery, Mortality, Nutrition",
author = "Kosei Takagi and Yuzo Umeda and Ryuichi Yoshida and Daisuke Nobuoka and Takashi Kuise and Takuro Fushimi and Toshiyoshi Fujiwara and Takahito Yagi",
year = "2018",
month = "4",
day = "19",
doi = "10.1159/000488215",
language = "English",
journal = "Digestive Surgery",
issn = "0253-4886",
publisher = "S. Karger AG",

}

TY - JOUR

T1 - Preoperative Controlling Nutritional Status Score Predicts Mortality after Hepatectomy for Hepatocellular Carcinoma

AU - Takagi, Kosei

AU - Umeda, Yuzo

AU - Yoshida, Ryuichi

AU - Nobuoka, Daisuke

AU - Kuise, Takashi

AU - Fushimi, Takuro

AU - Fujiwara, Toshiyoshi

AU - Yagi, Takahito

PY - 2018/4/19

Y1 - 2018/4/19

N2 - Background: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. Methods: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015. Patients were divided into 2 groups based on their CONUT score and the PNI. We evaluated the effect of the CONUT score and PNI on perioperative outcomes. Multivariate analysis was performed to identify independent predictors of in-hospital mortality after hepatectomy. ­Results: The high CONUT group had a significantly higher ­incidence of 30-day mortality (p < 0.001), in-hospital mortality (p = 0.002), ascites (p = 0.006), liver failure (p = 0.02), sepsis (p = 0.01), and enteritis (p < 0.001). The low PNI group was also significantly associated with 30-day mortality (p < 0.001), in-hospital mortality (p = 0.003), liver failure (p < 0.001), sepsis (p = 0.02), enteritis (p = 0.02), and hospital stay (p = 0.01). In multivariate analyses, a high CONUT score was an independent predictor of in-hospital mortality after hepatectomy (hazard ratio [HR] 9.41, p = 0.038), but the PNI was not (HR 5.86, p = 0.08). Conclusions: Preoperative assessment of the CONUT score is helpful for evaluating patients’ nutritional status and mortality risk after liver surgery.

AB - Background: Preoperative nutritional status is reportedly associated with postoperative outcomes in patients with hepatocellular carcinoma. This study aimed to investigate the significance of the controlling nutritional status (CONUT) score and the prognostic nutritional index (PNI) as predictors of postoperative outcomes. Methods: We retrospectively reviewed data from 331 patients who underwent hepatectomy for hepatocellular carcinoma between January 2007 and December 2015. Patients were divided into 2 groups based on their CONUT score and the PNI. We evaluated the effect of the CONUT score and PNI on perioperative outcomes. Multivariate analysis was performed to identify independent predictors of in-hospital mortality after hepatectomy. ­Results: The high CONUT group had a significantly higher ­incidence of 30-day mortality (p < 0.001), in-hospital mortality (p = 0.002), ascites (p = 0.006), liver failure (p = 0.02), sepsis (p = 0.01), and enteritis (p < 0.001). The low PNI group was also significantly associated with 30-day mortality (p < 0.001), in-hospital mortality (p = 0.003), liver failure (p < 0.001), sepsis (p = 0.02), enteritis (p = 0.02), and hospital stay (p = 0.01). In multivariate analyses, a high CONUT score was an independent predictor of in-hospital mortality after hepatectomy (hazard ratio [HR] 9.41, p = 0.038), but the PNI was not (HR 5.86, p = 0.08). Conclusions: Preoperative assessment of the CONUT score is helpful for evaluating patients’ nutritional status and mortality risk after liver surgery.

KW - Complications

KW - Hepatocellular cancer

KW - Liver surgery

KW - Mortality

KW - Nutrition

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U2 - 10.1159/000488215

DO - 10.1159/000488215

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C2 - 29672297

AN - SCOPUS:85045760911

JO - Digestive Surgery

JF - Digestive Surgery

SN - 0253-4886

ER -