Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study

Kim, Eunjung; Lee, Doo-Ho; Jang, Jin‐Young

doi:10.5009/gnl18469

Cited by 23 publications

(26 citation statements)

References 20 publications

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“…Pre-operative malnutrition is associated with significantly poorer post-operative outcomes for pancreatic resection, addressing this extends beyond just the prescribing of PERT [ 74 , 75 ]. The international Study Group on Pancreatic Surgery (ISGPS) released a position paper on nutritional support and therapy in pancreatic surgery, this emphasizes the importance of pre-operative assessment of nutritional status and recommends nutritional supplements in those who have, or are at risk of developing, moderate malnutrition [ 76 ].…”

Section: Pre-operative Pathwaysmentioning

confidence: 99%

Achieving ‘Marginal Gains’ to Optimise Outcomes in Resectable Pancreatic Cancer

Powell‐Brett

Pandé

Roberts

2021

Cancers

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Improving outcomes among patients with resectable pancreatic cancer is one of the greatest challenges of modern medicine. Major improvements in survival will result from the development of novel therapies. However, optimising existing pathways, so that patients realise benefits of already proven treatments, presents a clear opportunity to improve outcomes in the short term. This narrative review will focus on treatments and interventions where there is a clear evidence base to improve outcomes in pancreatic cancer, and where there is also evidence of variation and under-treatment. Avoidance of preoperative biliary drainage, treatment of pancreatic exocrine insufficiency, prehabiliation and enhanced recovery after surgery, reducing perioperative complications, optimising opportunities for elderly patients to receive therapy, optimising adjuvant chemotherapy and regular surveillance after surgery are some of the strategies discussed. Each treatment or pathway change represents an opportunity for marginal gain. Accumulation of marginal gains can result in considerable benefit to patients. Given that these interventions already have evidence base, they can be realised quickly and economically.

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Section: Pre-operative Pathwaysmentioning

confidence: 99%

Achieving ‘Marginal Gains’ to Optimise Outcomes in Resectable Pancreatic Cancer

Powell‐Brett

Pandé

Roberts

2021

Cancers

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“…Elderly patients (aged 65-90 years) were included if they were scheduled to undergo noncardiac surgery with an expected duration ≥ 2 h under general anesthesia. Patients who met any of the following criteria were excluded: (1) refused to participate in the study; (2) previous history of schizophrenia, epilepsy, Parkinson's Disease, or myasthenia gravis; (3) unable to communicate due to severe dementia, comatose or language barrier; (4) traumatic brain injury or neurosurgery; (5) an American Society of Anesthesiologists (ASA) classi cation of IV or above; or (6) Emergency surgery.…”

Section: Participantsmentioning

confidence: 99%

“…(3,4) Its incidence reaches up to 60%-86% in the elderly. (4,5) Malnutrition is associated with increased risk of morbidity (i.e., gastrointestinal stula, wound dehiscence, and infection) and mortality. (1)(2)(3)(4)(5) Delirium is one of the most common complications in elderly surgical patients.…”

Section: Introductionmentioning

confidence: 99%

“…(4,5) Malnutrition is associated with increased risk of morbidity (i.e., gastrointestinal stula, wound dehiscence, and infection) and mortality. (1)(2)(3)(4)(5) Delirium is one of the most common complications in elderly surgical patients. It is manifested as acute disturbance of attention and cognitive function, abnormal sleep cycle and disorganized thinking.…”

Section: Introductionmentioning

confidence: 99%

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Malnutrition Was Not Related With Emergence Delirium in Elderly Patients After Noncardiac Surgery

Zhang

et al. 2021

Preprint

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Background: Delirium is one of the most common complications in elderly surgical patients. Although previous studies reported that preoperative malnutrition was related with postoperative delirium (POD), there was lack of evidence to illustrate the relationship between malnutrition and emergency delirium (ED). The objective of this study was to investigate the relationship between preoperative malnutrition and ED in elderly patients undergoing noncardiac surgery.Methods: The study was carried out in accordance with STROBE guidelines. This was a secondary analysis of a prospective cohort study. Elderly patients (65-90 years) who underwent noncardiac surgery under general anesthesia were enrolled in Peking University First Hospital.Preoperative malnutrition was defined as nutritional risk screening 2002 (NRS 2002) ≥3. Emergence delirium was assessed by Confusion Assessment Method for intensive care unit at 10 and 30 min after Post-anesthesia care unit (PACU) admission, and before PACU discharge. Multivariable analysis was employed to analyze the relationship between malnutrition and emergence delirium.Results: 915 patients were enrolled. The incidence of malnutrition was 53.6% (490/915). The incidence of emergency delirium was 41.8% (205/490) in malnutrition group and 31.5% (134/425) in control group, P<0.001. After adjusting confounding factors (i.e., age, mild cognitive impairment, American Society of Anesthesiologists classification (ASA), duration of surgery, pain score, low body temperature and allogeneic blood transfusion), malnutrition was not associated with increased risk of emergency delirium (OR=1.055, 95% CI 0.767-1.452, P=0.742).Conclusions: Malnutrition was common in elderly patients undergoing non-cardiac surgery, but it’s not related with emergence delirium after adjusted for confounders.Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn) (Number: ChiCTR-OOC-17012734).

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“…It is estimated that 24-51 % of surgical patients are at risk of malnutrition [3,4]. Its incidence reaches up to 60-86 % in the older patients [4,5]. Malnutrition is associated with increased risk of morbidity (i.e., gastrointestinal fistula, wound dehiscence, and infection) and mortality [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Malnutrition is not related with emergence delirium in older patients after noncardiac surgery

Zhang

et al. 2021

BMC Geriatr

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Background Delirium is one of the most common complications in older surgical patients. Although previous studies reported that preoperative malnutrition was related with postoperative delirium (POD), there was lack of evidence to illustrate the relationship between malnutrition and emergency delirium (ED). The objective of this study was to investigate the relationship between preoperative malnutrition and ED in older patients undergoing noncardiac surgery. Methods The study was carried out in accordance with STROBE guidelines. This was a secondary analysis of a prospective cohort study. Older patients (65–90 years) who underwent noncardiac surgery under general anesthesia were enrolled in Peking University First Hospital. Results 915 patients were enrolled. The incidence of malnutrition was 53.6 % (490/915). The incidence of emergency delirium was 41.8 % (205/490) in malnutrition group and 31.5 % (134/425) in control group, P < 0.001. After adjusting confounding factors (i.e., age, cognitive impairment, American Society of Anesthesiologists classification (ASA), duration of surgery, pain score, low body temperature and allogeneic blood transfusion), malnutrition was not associated with increased risk of emergency delirium (OR = 1.055, 95 % CI 0.767–1.452, P = 0.742). Conclusions Malnutrition was common in older patients undergoing non-cardiac surgery, but it’s not related with emergence delirium after adjusted for confounders. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn) (ChiCTR-OOC-17,012,734).

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Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study

Cited by 23 publications

References 20 publications

Achieving ‘Marginal Gains’ to Optimise Outcomes in Resectable Pancreatic Cancer

Achieving ‘Marginal Gains’ to Optimise Outcomes in Resectable Pancreatic Cancer

Malnutrition Was Not Related With Emergence Delirium in Elderly Patients After Noncardiac Surgery

Malnutrition is not related with emergence delirium in older patients after noncardiac surgery

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