Pulmonary Dysfunction Function and Poor Nutritional Status are Risk Factors for Remote Infections Following Surgery for Colorectal Cancer.

OBJECTIVE: We evaluated the preoperative patient status including nutrition, immunity, and inflammation as a predictive factor of remote infection (RI) in colorectal cancer surgery.

SUBJECTS AND METHODS: A total of 351 patients who underwent colorectal cancer resection were retrospectively analyzed. Factors correlated with RI incidence were identified by logistic analysis and stepwise selection.

RESULTS: RI occurred in 27 patients, with an incidence of 7.7%. In univariate logistic analysis, a significantly high incidence of RI was associated with excessive blood loss (>423 mL), long duration of surgery (>279 minutes), ileus, pulmonary dysfunction, performance status (PS) ≥1, American Society of Anesthesiologists (ASA) classification>2, prognostic nutritional index (PNI) ≤40, and controlling nutritional status (CONUT) ≥2, modified Glasgow Prognostic Score (mGPS) (Score 2).In multivariate analysis, pulmonary dysfunction (odds ratio=2.83; 95% CI: 1.14-6.97; p=0.02) and PNI≤40 (odds ratio=3.87; 95% CI: 1.45-10.31; p=0.006) were independent risk factors of RI incidence.

CONCLUSION: RI is caused by poor nutrition, immune system dysfunction and pulmonary dysfunction.