ORIGINAL RESEARCH article
Front. Nutr.
Sec. Clinical Nutrition
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1651741
This article is part of the Research TopicThe Role of Nutrition in Enhancing Surgical Recovery and OutcomesView all 3 articles
Prognostic Risk Factors in Upper Gastrointestinal Perforation: The Role of Body Composition Parameters
Provisionally accepted
- 1The First Affiliated Hospital of Wenzhou Medical University Department of Gastroenterology, Wenzhou, China
- 2The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Background: Despite medical advances, the prognosis for upper gastrointestinal perforation remained poor. The aim of our study was to identify predictors of adverse outcomes.We retrospectively analyzed laboratory data from patients with upper gastrointestinal perforation at the First Affiliated Hospital of Wenzhou Medical University (January 2021 to December 2023), categorizing them according to septic shock, ICU admission, and postoperative complications.Results: Univariate and multivariate analyses of 200 patients with upper gastrointestinal perforation identified predictors of a poor prognosis: Low muscle reserve (OR=3.82, 95% CI 1.36-10.71, P=0.011), high visceral fat area (VFA) (OR=3.54, 95% CI 1.16-10.80, P=0.026), and Platelet-to-Lymphocyte Ratio (PLR) (OR=1.01, 95% CI 1.01-1.01, P=0.048) predicted septic shock. Sex (OR=0.22, 95% CI 0.06-0.78, P=0.020), high VFA (OR=4.84, 95% CI 1.38-17.02, P=0.014), prothrombin time (PT) (OR=1.54, 95% CI 1.09-2.18, P=0.014), and D-dimer (OR=1.16, 95% CI 1.01-1.34, P=0.048) influenced ICU admission. Meanwhile, surgical approach (OR=7.82, 95% CI 1.94-31.57, P=0.004), maximum perforation diameter (OR=1.08, 95% CI 1.02-1.15, P=0.013), and white blood cell (WBC) count (OR=0.88, 95% CI 0.78-0.99, P=0.039) were linked to postoperative complications.Our research found that the following factors were prognostic for upper gastrointestinal perforation: low muscle reserve, high VFA, PLR, sex, PT, D-dimer levels, surgical approach, WBC count and perforation size .
Keywords: Upper gastrointestinal perforation, prognosis, Body Composition, predictive model, Risk factors
Received: 22 Jun 2025; Accepted: 08 Aug 2025.
Copyright: © 2025 Zhu, Gu, Chen, Huang, Chen and Hong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiangjian Chen, The First Affiliated Hospital of Wenzhou Medical University Department of Gastroenterology, Wenzhou, China
Wandong Hong, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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