A nomogram model based on the combination of the systemic immune-inflammation index and prognostic nutritional index predicts weight regain after laparoscopic sleeve gastrectomy

Background: The high rate of weight regain after laparoscopic sleeve gastrectomy is a great chal-lenge. The systemic immune-inflammation index (SII; calculated by neutrophils, lymphocytes, and platelets) and prognostic nutritional index (PNI; calculated by albumin and lymphocytes) are widely used as prognostic factors in various diseases.Objectives: The objective of this study was to investigate independent the independent risk factors associated with weight regain in patients after laparoscopic sleeve gastrectomy.Setting: A single-center retrospective study.Methods: Weight regain was defined as the percentage of increase in body weight >10% in comparison with the nadir weight postoperatively. Eligible patients admitted to the bariatric center of our hospital were consecutively enrolled and grouped according to the occurrence of weight regain within 5 postoperative years. Univariate and multivariate logistic regression analyses were performed to assess potential risk fac-tors. A nomogram model containing the risk factors was then constructed and evaluated by R.Results: A total of 217 patients were enrolled, and 87 (40.1%) patients experienced weight regain. Univariate and logistic regression analyses indicated that depression (odds ratio [OR]: 2.51, 95% con-fidence interval [CI]: 1.20-5.22, P = .015), psychological counseling (OR: 2.27, 95% CI: 1.20-4.33, P =.017), preoperative C-reactive protein (OR: 2.20, 95% CI: 1.18-4.13, P =.012), and combination of SII-PNI scores (OR: .45, 95% CI: .31-.67, P , .001) were 4 independent risk factors for postop-erative weight regain in laparoscopic sleeve gastrectomy patients. The area under the curve of the constructed nomogram model for predicting weight regain was .706.Conclusions: This study concluded that the combination of the SII-PNI was an independent risk fac-tor for weight regain and that the nomogram model based on the combination of the SII-PNI had a good predictive value. (Surg Obes Relat Dis 2023;19:50-58.) (c) 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.