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

Retrospective Study

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

Table 1 Comparison of baseline characteristics between the two patient groups, mean ± SD

Characteristics	Ineffective group (n = 32)	Effective group (n = 154)	χ²/t value	P value
Sex			0.292	0.589
Male	18	130
Female	14	124
Age (year)	60.68 ± 4.81	61.13 ± 5.04	0.478	0.633
Body mass index (kg/m²)	20.88 ± 1.36	21.07 ± 1.40	0.716	0.475
Tumor type			0.206	0.977
Gastric cancer	11	54
Esophageal cancer	8	41
Colorectal cancer	10	48
Other	3	11
Clinical stage			0.010	0.995
Stage I	9	42
Stage II	15	73
Stage III	8	39
Hypertension	6	18	0.631	0.427
Diabetes mellitus	5	12	1.128	0.288
Nutritional Risk Screening 2002 score	4.48 ± 1.05	4.52 ± 1.10	0.194	0.846
Operative time (minute)	252.68 ± 38.48	248.69 ± 41.67	0.526	0.599

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Table 2 Comparison of serum prealbumin, albumin, and transferrin levels between the two groups, mean ± SD

Group	Parameter	Prior to nutritional support	POD1	POD3	POD7	POD14	F value	P value
Effective group (n = 154)	PA (mg/L)	231.14 ± 25.84	198.41 ± 18.31	205.60 ± 20.74	234.84 ± 23.67^a	251.86 ± 23.14^a	147.478	< 0.001
	ALB (g/L)	38.81 ± 3.04	32.12 ± 2.48	33.76 ± 2.63	39.08 ± 2.92^a	45.82 ± 3.14^a	546.320	< 0.001
	TF (g/L)	2.18 ± 0.21	1.91 ± 0.24	1.93 ± 0.35	2.48 ± 0.27^a	3.10 ± 0.30^a	484.259	< 0.001
Ineffective group (n = 32)	PA (mg/L)	228.84 ± 26.36	195.74 ± 20.63	202.60 ± 18.75	206.64 ± 18.74	210.14 ± 21.63	10.773	< 0.001
	ALB (g/L)	38.63 ± 2.84	31.92 ± 2.53	33.08 ± 2.70	36.17 ± 2.41	37.08 ± 2.78	35.518	< 0.001
	TF (g/L)	2.19 ± 0.20	1.90 ± 0.24	1.91 ± 0.26	2.12 ± 0.30	2.18 ± 0.29	9.785	< 0.001

^aP < 0.05 vs the invalid group.

ALB: Albumin; PA: Prealbumin; POD: Postoperative day; TF: Transferrin.

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Table 3 Comparison of serum C-reactive protein and interleukin-6 levels between the two groups, mean ± SD

Group	Index	Prior to nutritional support	Nutritional support POD1	Nutritional support POD3	Nutritional support POD7	Nutritional support POD14	F value	P value
Effective group (n = 154)	CRP (mg/L)	12.93 ± 2.84	42.41 ± 3.15	38.82 ± 4.20	23.47 ± 2.20^a	14.61 ± 2.12^a	3166.461	< 0.001
Effective group (n = 154)	IL-6 (pg/mL)	13.69 ± 3.14	48.85 ± 4.82	46.65 ± 4.75	28.80 ± 2.73^a	21.13 ± 2.49^a	2672.053	< 0.001
Ineffective group (n = 32)	CRP (mg/L)	13.10 ± 2.96	41.47 ± 4.50	39.40 ± 4.85	33.12 ± 3.36	30.28 ± 3.60	262.806	< 0.001
Ineffective group (n = 32)	IL-6 (pg/mL)	14.08 ± 3.26	50.13 ± 5.15	47.47 ± 5.63	41.76 ± 3.25	40.50 ± 3.08	371.791	< 0.001

^aP < 0.05 vs the invalid group.

CRP: C-reactive protein; IL: Interleukin; POD: Postoperative day.

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Table 4 Comparison of gastrointestinal function recovery between the two groups (day), mean ± SD

Group	First exhaust time	Gastric emptying time	Normal meal times	Hospital length of stay
Effective group (n = 154)	2.14 ± 1.51	8.82 ± 2.49	10.40 ± 3.28	24.63 ± 2.78
Ineffective group (n = 32)	3.08 ± 1.75	15.73 ± 2.60	14.10 ± 3.36	28.75 ± 3.63
t value	3.115	14.177	5.782	7.212
P value	0.002	< 0.001	< 0.001	< 0.001

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Table 5 Predictive power of serum biomarkers on postoperative day 7 for the efficacy rate of parenteral nutrition support

Serum indicators	AUC	Sensitivity (%)	Specificity (%)	P value	SE	95%CI
Serum PA	0.677	65.60	64.30	0.012	0.0464	0.586-0.768
Serum CRP	0.711	56.25	81.17	0.010	0.0587	0.596-0.826
Serum PA combined with CRP	0.900	78.10	88.30	-	0.0294	0.843-0.958

AUC: Area under the curve; CRP: C-reactive protein; PA: Prealbumin.

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Table 6 Predictive efficacy of serum markers on postoperative day 14 of nutritional support for the efficacy rate of parenteral nutrition support

Serum indicators	AUC	Sensitivity (%)	Specificity (%)	P value	SE	95%CI
Serum PA	0.698	75.00	72.73	0.008	0.0462	0.608-0.789
Serum CRP	0.727	59.38	97.40	0.006	0.0647	0.600-0.854
Serum PA combined with CRP	0.956	87.50	93.50	-	0.0187	0.920-0.993

AUC: Area under the curve; CRP: C-reactive protein; PA: Prealbumin.

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Citation: Zhang T, Li XX, Xiang FF, Wu R, Zhong ZR, Zhao Q. Serum prealbumin and C-reactive protein levels to evaluate parenteral nutrition efficacy in critically ill patients with gastrointestinal tumors. World J Gastrointest Surg 2026; 18(10): 121410
URL: https://www.wjgnet.com/1948-9366/full/v18/i10/121410.htm
DOI: https://dx.doi.org/10.4240/wjgs.121410

Zhang T, Li XX, Xiang FF, Wu R, Zhong ZR, Zhao Q. Serum prealbumin and C-reactive protein levels to evaluate parenteral nutrition efficacy in critically ill patients with gastrointestinal tumors. World J Gastrointest Surg 2026; 18(10): 121410 [DOI: 10.4240/wjgs.121410]

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