Preoperative prognostic nutritional index predicts postoperative surgical site infections in gastrointestinal fistula patients

Objective To explore the predictive value of prognostic nutritional index (PNI) in surgical site infections (SSIs) for intestinal fistula patients undergoing bowel resections. Methods Clinical data of 290 gastrointestinal fistula patients who underwent intestinal resections between 2012 and 2015 were retrospectively reviewed. Univariate and multivariate analyses were conducted to identify risk factors for SSIs, and receiver operating characteristic (ROC) curve was used to quantify the effectiveness of PNI. Results SSIs were diagnosed in 99(34.1%) patients. ROC curve analysis defined a PNI cut-off level of 45 corresponding to postoperative SSIs (area under the curve=0.72, 76% sensitivity, 55% specificity). Furthermore, a multivariate analysis indicated that the PNI<45 (OR: 2.24, 95% CI: 1.09-4.61, P=0.029) and preoperative leukocytosis (OR: 3.70, 95% CI: 1.02-13.42, P=0.046) were independently associated with postoperative SSIs. Conclusions Preoperative PNI is useful to predict SSIs in intestinal fistulae patients after enterectomies. Key words: Intestinal fistula; Nutritional assessment; Surgical wound infection