Impact of controlling nutritional status score on perioperative outcomes in esophageal cancer patients with COPD undergoing thoracoabdominal McKeown surgery

LU Wei; SUN Bo; WEI Yu-tao

doi:10.13820/j.cnki.gdyx.20251322

Abstract：Objective To investigate the impact of the controlling nutritional status(CONUT)score on perioper-ative outcomes in esophageal cancer patients with chronic obstructive pulmonary disease(COPD)undergoing thoracoab-dominal McKeown surgery and to explore possible underlying mechanisms.Methods A total of 134 esophageal cancer patients were included.The optimal CONUT cutoff value was determined using receiver operating characteristic(ROC)curve analysis.Patients were divided into Group A(CONUT score 4-12)and Group B(CONUT score 0-3).Perioper-ative outcomes,including postoperative pulmonary infection,respiratory failure,drainage tube retention time,antibiotic usage duration,average length of hospital stay,and perioperative neutrophil-to-lymphocyte ratio(NLR),were com-pared between groups.Multivariate stepwise regression analysis was used to identify factors affecting postoperative pulmo-nary infection.Results The incidence of postoperative pulmonary infection and respiratory failure was significantly higher in Group A than in Group B(P＜0.05).Group A also had longer durations of antibiotic usage,drainage tube retention,and hospital stay compared to Group B(P＜0.05).Perioperative NLR was significantly higher in Group A than in Group B(P＜0.01).Multivariate regression analysis showed that the CONUT score was an independent risk factor for postopera-tive pulmonary infection(P＜0.05).Conclusion The CONUT score is a significant predictor of perioperative infectious complications in esophageal cancer patients with COPD undergoing thoracoabdominal McKeown surgery.Higher CONUT scores are associated with increased risk of postoperative pulmonary infection,prolonged antibiotic therapy,longer drain-age tube retention,and extended hospital stay.