Topical Area: Medical Nutrition
Objectives :
Postoperative pulmonary complications (PPCs) significantly impact surgical outcome, but the clinical usefulness of various models used to predict PPCs is questionable. The controlling nutritional status (CONUT) score reflects nutritional deficiency and inflammation and is used to predict clinical outcomes in various malignancies. We aimed to investigate the ability of the CONUT score to predict PPCs after lung resection in patients with non-small cell lung cancer (NSCLC).
Methods :
We retrospectively reviewed data of 922 patients with NSCLC who underwent complete resection at Severance Hospital in South Korea during January 2016–December 2017. We analyzed the predictability of the CONUT score for PPCs compared with other inflammatory prognostic markers and PPCs risk scoring systems (prognostic nutritional index [PNI], Glasgow prognostic score [GPS], and assessment of respiratory risk in surgical patients in Catalonia [ARISCAT] score) using receiver operating characteristic curves analysis.
Results :
Of 922 study subjects, 522 (56.6%) were male; the mean age was 64.2 years. Lobectomy was the most common type of operation (n=737, 79.9%). Total incidence of PPCs was 8.6% (n=79). Prolonged air leak (44.3%) was the most common PPC, followed by pneumonia (32.9%) and pneumothorax (11.4%). The proportion of pneumonia was significantly larger in the high CONUT group (P < 0.05). The CONUT consistently had a higher area under curve (AUC) value (0.64) than other prognostic models (PNI: AUC = 0.61, GPS: AUC = 0.57, and ARISCAT: AUC = 0.54). Multivariate analysis identified male sex (odds ratio [OR] = 1.94), low body mass index (OR = 4.57), and high CONUT score (OR = 1.91) as independent PPCs prognostic factors. Kaplan-Meier analysis revealed a significantly higher 1-year mortality rate for the high CONUT group (hazard ratio = 7.97; 95% confidence interval, 1.78-35.59).
Conclusions :
Preoperative CONUT score is an independent predictor of PPCs and 1-year mortality in patients with NSCLC.
Funding Sources : None
Ji Ye Jung
Severance Hospital, Yonsei University College of Medicine
Ah Young Leem
Yonsei University College of Medicine
Sang Chul Lee
Severance Hospital, Yonsei University College of Medicine
Eun Young Kim
Severance Hospital, Yonsei University College of Medicine
Sang Hoon Lee
Severance Hospital, Yonsei University College of Medicine
Joon Chang
Severance Hospital, Yonsei University College of Medicine
Kyung Young Chung
Severance Hospital, Yonsei University College of Medicine
Hyo Chae Paik
Severance Hospital, Yonsei University College of Medicine
Dae Joon Kim
Severance Hospital, Yonsei University College of Medicine
Jin Gu Lee
Severance Hospital, Yonsei University College of Medicine
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