Serum prealbumin and C-reactive protein levels to evaluate parenteral nutrition efficacy in critically ill patients with gastrointestinal tumors

doi:10.4240/wjgs.121410

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World Journal of Gastrointestinal Surgery

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1948-9366

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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 Gastrointest Surg. Oct 27, 2026; 18(10): 121410
Published online Oct 27, 2026. doi: 10.4240/wjgs.121410

Serum prealbumin and C-reactive protein levels to evaluate parenteral nutrition efficacy in critically ill patients with gastrointestinal tumors

Tao Zhang, Xiao-Xiao Li, Fen-Fen Xiang, Rong Wu, Zheng-Rong Zhong, Qi Zhao

Tao Zhang, Xiao-Xiao Li, Fen-Fen Xiang, Rong Wu, Zheng-Rong Zhong, Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, China

Qi Zhao, Department of Laboratory Medicine, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200062, China

Co-first authors: Tao Zhang and Xiao-Xiao Li.

Co-corresponding authors: Zheng-Rong Zhong and Qi Zhao.

Author contributions: Zhang T and Li XX contributed equally as co-first authors and they were responsible for study design, data collection, statistical analysis, and manuscript drafting; Zhong ZR and Zhao Q were co-corresponding authors and they were responsible for project supervision, critical revision, and final approval of the manuscript; Xiang FF and Wu R participated in data collection and the literature review; and all authors approved the final version.

AI contribution statement: The authors declare that no AI tools were utilized in the drafting, writing or polishing of this manuscript, and all content was independently completed by the authors, who take full responsibility for the integrity, accuracy and originality of the work.

Supported by Sanghai Putuo Central Hospital Talent Introduction Program, No. 2024-YJRC-09; and Shanghai Putuo Central Hospital Discipline Construction Project, No. 2024xkjs03.

Institutional review board statement: This study has been reviewed and approved by the Ethics Committee of Putuo Hospital, Shanghai University of Traditional Chinese Medicine [Approval No. PTEC-A-2026-5(S)-1].

Informed consent statement: All the individuals who participated in this study provided their written informed consent prior to study enrolment.

Conflict-of-interest statement: The authors declare no conflicts of interest.

Data sharing statement: No additional data are available.

Corresponding author: Qi Zhao, Research Fellow, Department of Laboratory Medicine, Shanghai Children’s Hospital, School of Medicine, Shanghai Jiao Tong University, No. 355 Luding Road, Putuo District, Shanghai 200062, China. zq198502142022@163.com

Received: April 28, 2026
Revised: June 9, 2026
Accepted: June 24, 2026
Published online: October 27, 2026
Processing time: 173 Days and 0.8 Hours

Abstract

BACKGROUND

Evaluating the efficacy of parenteral nutrition support and providing a reference for postoperative nutritional support in patients undergoing surgery for gastrointestinal tumors is important.

AIM

To investigate the value of combined detection of serum prealbumin (PA) and C-reactive protein (CRP) in assessing the efficacy of parenteral nutrition support for critically ill patients with gastrointestinal tumors, and to provide an evidence-based reference for clinical precision.

METHODS

This retrospective study comprised clinical data concerning 186 critically ill patients with gastrointestinal tumors admitted to the Surgical Ward of Putuo Hospital, Shanghai University of Traditional Chinese Medicine, from August 2023 to August 2025. All patients underwent radical gastrointestinal tumor resection and received total parenteral nutrition support on postoperative day (POD) 1. Venous blood samples were collected from patients before nutritional support, and thereafter on PODs 1, 3, 7, and 14 of parenteral nutrition support to measure serum PA, CRP, albumin (ALB), transferrin (TF), and interleukin-6 (IL-6) levels. According to the efficacy of parenteral nutrition support on POD14, we divided the patients into an effective or ineffective support groups. Between-group differences in serum indicators and prognostic outcomes were compared. A receiver operating characteristic curve was used to evaluate the value of serum indicators in assessing and effectively predicting the efficacy of parenteral nutrition support.

RESULTS

Of 186 critically ill patients with gastrointestinal tumors, after 14 days of parenteral nutrition support, 32 (17.20%) patients had ineffective nutritional support and 154 (82.80%) had effective nutritional support. On POD1 and POD3 of parenteral nutrition support, serum PA, ALB, and TF levels in both groups were significantly lower than those prior to nutritional support (P < 0.05). In both groups, these levels were significantly increased on POD7 and POD14, compared with those on POD1 and POD3 (P < 0.05). In the effective support group, serum PA, ALB, and TF levels were significantly higher than those in the ineffective support group on POD7 and POD14 (P < 0.05). On POD1 and POD3, serum CRP and IL-6 levels in both groups were significantly higher than those before nutritional support (P < 0.05). In both groups, these levels were significantly decreased on POD7 and POD14, compared with those on POD1 and POD3 (P < 0.05). Serum CRP and IL-6 levels in the effective support group were significantly lower than those in the ineffective support group on POD7 and POD14 (P < 0.05). The time to first flatus, gastric emptying time, time to resumption of normal diet, and hospital stay in the effective support group were significantly shorter than those in the ineffective support group (P < 0.05). With serum PA and CRP levels on POD7 and POD14 of nutritional support as independent variables and the efficacy of parenteral nutrition support as the dependent variable, the efficacy of combined detection of serum PA and CRP in predicting the efficacy of parenteral nutrition support was significantly higher than that of single serum indicators (P < 0.05). The predictive efficacy of serum indicators on POD14 was slightly higher than that POD7, with no statistically significant difference (P > 0.05).

CONCLUSION

Dynamic monitoring of changes in serum PA and CRP levels can effectively evaluate the nutritional status and inflammatory level of critically ill patients with gastrointestinal tumors after parenteral nutrition support. The combined detection of serum PA and CRP levels can accurately predict the efficacy of parenteral nutrition support in such patients, providing a reliable reference for the adjustment of clinical nutritional support regimens.

Keywords: C-reactive protein; Critical illness; Gastrointestinal tumor; Parenteral nutrition support; Prealbumin

Core Tip: This study demonstrates that dynamic monitoring of serum prealbumin and C-reactive protein levels can effectively assess the nutritional and inflammatory status of critically ill gastrointestinal tumor patients after parenteral nutrition. The combined detection of these two indicators enables precise prediction of parenteral nutrition efficacy, providing a reliable reference for adjusting clinical nutritional support strategies.