Factors associated with failure of preoperative optimization with exclusive enteral nutrition in patients with Crohn's disease
10.16151/j.1007-810x.2025.02.003
- VernacularTitle:克罗恩病病人术前单一肠内营养优化失败的影响因素分析
- Author:
Yi-Xiao WANG
1
;
Teng-Hui ZHANG
;
Lei CAO
;
Jian-Feng GONG
Author Information
1. 南京中医药大学金陵临床医学院,江苏 南京 210002
- Keywords:
Crohn's disease;
Exclusive enteral nutrition;
Preoperative optimization;
Predictive factors;
Nomogram
- From:
Parenteral & Enteral Nutrition
2025;32(2):75-80
- CountryChina
- Language:Chinese
-
Abstract:
objective:To investigate the factors influencing failure of preoperative optimisation with exclusive enteral nutrition(EEN)in patients with Crohn's disease(CD)and to construct a predictive model.Methods:Clinical data of 161 patients with Crohn's disease who underwent surgical treatment after preoperative EEN optimization at the Inflammatory Bowel Disease Center of General Surgery of the Eastern Theater General Hospital from June 2021 to November 2023 were retrospectively analyzed.Patients were divided into two groups according to the preoperative EEN optimisation effect:optimisation success and optimisation failure.Logistic regression analysis was used to determine the factors influencing optimisation failure,and a column line graphical model was constructed using R4.4.0 software.Results:After at least 4 weeks of EEN treatment,a total of 44 patients(27.33%)failed preoperative optimization.Multifactorial analysis showed that FC>500 μg/g and use of corticosteroids were independent risk factors for failure of preoperative optimization,and an increase in prealbumin after 1 week of treatment was a protective factor for successful preoperative optimization.Based on the results of the multivariate analysis,a column graph was constructed,and the C-index was 0.873(95%CI=0.783～0.964).The calibration curve shows that the probability of failure predicted by the nomogram model prior to optimization is in good agreement with the actual probability.The clinical decision curve confirms that the risk threshold is between 0.03～0.96,and the nomogram model can be used to predict the failure of preoperative EEN optimization over other treatment options.Conclusion:FC>500μg/g and history of corticosteroid use were independent risk factors for failure of preoperative optimization,and an increase in prealbumin after 1 week of treatment was a protective factor for successful preoperative optimization.The nomogram constructed on the basis of these results has a good predictive value and is clinically applicable.
