Nutritional risk index as a predictor of postoperative wound complications after gastrectomy

AIM: To investigate the correlation between the nutritional risk index (NRI) and postoperative wound complications. METHODS: From January 2008 through June 2008, 669 patients who underwent curative gastrectomy for gastric cancer were included in a retrospective study. Medical records of consecutive patients were collected and analyzed to determine postoperative wound complication rates. The NRI was assessed on the fifth postoperative day and other possible risk factors for the incidence of wound complications were analyzed to identify the factors affecting postoperative wound complications. Patients with other postoperative complications were excluded from the study. RESULTS: On the 5th postoperative day, the NRI showed a malnutrition rate of 84.6% among postoperative patients. However, postoperative wound complications occurred in only 66/669 (9.86%) patients. Of the patients with wound complications, 62/66 (94%) belonged to the malnourished group (NRI < 97.5), and 4/66 (6%) patients to the non-malnourished group (NRI >= 97.5). The only factor correlated with wound complications was the NRI on the 5th postoperative day (odds ratio of NRI >= 97.5 vs NRI < 97.5: 0.653; 95% confidence interval: 0.326-0.974; P = 0.014) according to univariate analysis as well as multivariate analysis. CONCLUSION: This study suggests that malnutrition immediately after surgery may play a significant role in the development of wound complications. (C) 2012 Baishideng. All rights reserved.