NUTRITIONAL RISK AND ANASTOMOTIC LEAKAGE: PREDICTIVE VALUE OF THE CONUT SCORE IN HARTMANN’S REVERSAL giselaoropeza@outlook.com

411-04

NUTRITIONAL RISK AND ANASTOMOTIC LEAKAGE: PREDICTIVE VALUE OF THE CONUT SCORE IN HARTMANN’S REVERSAL

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Juan Antonio Villanueva Herrero giselaoropeza@outlook.com Hospital General de México Coloproctology Ciudad de México Mexico

Billy Jiménez Bobadilla giselaoropeza@outlook.com Hospital General de México Coloproctology Ciudad de México Mexico

Mexico

Oral or Poster

The CONUT score is a validated tool for assessing nutritional risk and has proven useful in predicting postoperative outcomes across various conditions, including gastric and colorectal cancers. While specific references to CONUT in the context of anastomotic leakage are lacking, previous studies have shown that malnutrition-related indicators are associated with increased risk of leakage in colorectal cancer patients.

A retrospective, observational and analytical study was performed.

In a cohort of 55 patients undergoing colorectal anastomosis, the association between the nutritional CONUT score and the occurrence of anastomotic leakage was evaluated, 7 patients (12.7%) developed postoperative leakage. The ROC curve analysis revealed an AUC of 0.746 (95% CI: 0.542–0.949; p = 0.018), indicating acceptable discriminatory capacity of the CONUT score to predict leakage. The optimal cut-off was identified at CONUT ≥ 2, achieving a sensitivity of 71.4% and a specificity of 81.2%. A bivariate Spearman correlation showed a statistically significant negative association between CONUT and leakage (rho = -0.300; p = 0.026), suggesting that higher CONUT values are associated with increased risk of postoperative complications. Additionally, patients who developed leakage exhibited higher levels of C-reactive protein (CRP) on postoperative days 3 and 5, with a statistically significant difference on day 5 (p < 0.001). Reintervention (p < 0.001) and the presence of other postoperative complications (p = 0.001) were also significantly associated with leakage.

The CONUT score could be a useful tool to identify patients at increased nutritional risk, who may benefit from intensified perioperative monitoring and preventative strategies.