Nutritional risk index as an independent predictive factor for the development of surgical site infection after pancreaticoduodenectomy.
OBJECTIVE
Malnutrition has been considered a risk factor for the development of a surgical site infection (SSI). The aim of this study was to determine the relationship between preoperative nutritional screening scores and the development of SSI after pancreaticoduodenectomy.


METHODS
We examined 64 patients who had undergone pancreaticoduodenectomy. Their clinical data, nutritional risk index (NRI), and nutritional risk screening 2002 (NRS-2002) score were recorded. SSIs were diagnosed according to the definitions of wound infection established by the Center for Disease Control and Prevention and were confirmed by a microbiological examination. Data were analyzed using the Fisher exact probability method and a multivariate logistic regression analysis.


RESULTS
SSIs developed in 21 patients (33 %). Eleven patients had wound infections, and 14 patients had an intra-abdominal abscess. A univariate analysis of perioperative factors revealed that a pancreatic fistula, the NRS-2002, and the NRI were significantly associated with the development of SSI (p < 0.05). The multivariate logistic regression analysis revealed that a pancreatic fistula and the NRI were independent risk factors for SSI. By analyzing the pre- and intra-operative factors after excluding the 11 patients with pancreatic fistulas, the NRI was still an independent risk factor for SSI.


CONCLUSIONS
The present study showed the NRI to be an independent factor for predicting the risk of SSI after pancreaticoduodenectomy.
Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan. m1297198@msic.med.osaka-cu.ac.jp
Hiroji
H
Shinkawa
Shigekazu
S
Takemura
Takahiro
T
Uenishi
Masayuki
M
Sakae
Kazunori
K
Ohata
Yorihisa
Y
Urata
Kazuhisa
K
Kaneda
Akinori
A
Nozawa
Shoji
S
Kubo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult