Association of prealbumin with risk of abdominal surgery and endoscopic recurrence in Crohn’s disease: A machine learning study

doi:10.3748/wjg.119629

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Sep 28, 2026; 32(36): 119629
Published online Sep 28, 2026. doi: 10.3748/wjg.119629

Association of prealbumin with risk of abdominal surgery and endoscopic recurrence in Crohn’s disease: A machine learning study

Kai-Ling Xie, Gang Long, Lian-Wen Yuan, Dan Zhang

Kai-Ling Xie, Gang Long, Lian-Wen Yuan, Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China

Kai-Ling Xie, Gang Long, Lian-Wen Yuan, Department of Geriatric Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China

Dan Zhang, Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China

Co-corresponding authors: Lian-Wen Yuan and Dan Zhang.

Author contributions: Xie KL, Long G, Yuan LW, and Zhang D contributed to conceptualization, data curation, formal analysis, visualization, writing-original draft, review and editing, and funding acquisition; Yuan LW and Zhang D contributed equally as co-corresponding authors. All authors approved the final version to publish.

Supported by National Natural Science Foundation of China, No. 82270590; Hunan Provincial Natural Science Foundation, No. 2025JJ50584; Fundamental Research Funds for the Central Universities of Central South University, No. 2024ZZTS0959; and Research Project on Degree and Graduate Education Reform at Central South University.

Institutional review board statement: This study was approved by the Ethics Committee of The Second Xiangya Hospital, Central South University, No. LYEC2025-0156.

Informed consent statement: As this is a retrospective study, the requirement for informed consent was waived in accordance with local laws and institutional regulations.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: The datasets utilized in the present study can be obtained from the corresponding author upon reasonable request.

Corresponding author: Dan Zhang, Professor, Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, No. 139 Renmin Middle Road, Changsha 410011, Hunan Province, China. dunbaby@126.com

Received: February 2, 2026
Revised: March 31, 2026
Accepted: April 23, 2026
Published online: September 28, 2026
Processing time: 201 Days and 6.3 Hours

Core Tip

Core Tip: Serum prealbumin (PA), reflecting inflammatory and nutritional status, may serve as a pragmatic biomarker for risk stratification in Crohn’s disease. Higher PA levels were associated with lower risks of abdominal surgery and postoperative endoscopic recurrence (highest vs lowest quartile: Hazard ratio = 0.45 and 0.20, respectively). Incorporating PA into machine learning models further improved prognostic performance (C-index = 0.784 for surgery and 0.764 for recurrence). Moreover, serum PA showed approximately 70% concordance with machine learning-derived risk tiers and helped identify patients more likely to benefit from biologic therapy, thereby supporting earlier risk prediction and more individualized treatment decisions.