Inflammatory and nutritional statuses of patients submitted to resection of gastrointestinal tumors

Abstract

Objective: to evaluate the association between the nutritional and the inflammatory statuses of patients with cancer of the gastrointestinal tract undergoing surgical resection and to identify predictors of mortality in these patients. Methods: we conducted a prospective study of 41 patients with gastrointestinal tract cancer submitted to surgery between October 2012 and December 2014. We evaluated the nutritional status by subjective and objective methods. We assessed the inflammatory response and prognosis using the modified Glasgow Prognostic Score (mGPS), Neutrophil/Lymphocyte Ratio (NLR), Onodera Prognostic Nutritional Index (mPNI), Inflammatory-Nutritional Index (INI) and C-Reactive Protein/Albumin ratio (mPINI). Results: half of the patients were malnourished and 27% were at nutritional risk. There was a positive association between the percentage of weight loss (%WL) and the markers NLR (p=0.047), mPINI (p=0.014) and INI (p=0.015). Serum albumin levels (p=0.015), INI (p=0.026) and mPINI (p=0.026) were significantly associated with the PG-SGA categories. On multivariate analysis, albumin was the only inflammatory marker independently related to death (p=0.004). Conclusion: inflammatory markers were significantly associated with malnutrition, demonstrating that the higher the inflammatory response, the worse the PG-SGA (B and C) scores and the higher the %WL in these patients. However, further studies aimed at improving surgical outcomes and determining the role of these markers as predictors of mortality are required.

Risk Factors for Undernutrition at Admission Among Adult Hospitalized Patients at a Referral Hospital in Indonesia

“…NLR scores were not associated with undernutrition at admission. This is consistent with the results by Fruchtenicht et al (2018) in Brazil. We hypothesize that this insignificant result could be due to the duration of the inflammatory changes which was not long enough to cause significant changes in nutritional status.…”

Estado Nutricional e Qualidade de Vida em Indivíduos com Câncer Assistidos por Organização não Governamental

“…O grande número de indivíduos procedentes de outros municípios da região pode ser explicado pela natureza do estabelecimento que proporciona, aos indivíduos em tratamento oncológico ou acompanhamento, área para repouso e convívio social, alimentação adequada, além de orientação de equipe multidisciplinar 16 . Neste estudo, pacientes com neoplasias de órgãos digestivos e do sistema respiratório apresentaram maior desnutrição; esse achado é compatível com o notado por outros pesquisadores 2,[21][22][23] . A desnutrição pode ser resultado do maior gasto energético, dificuldades na ingestão alimentar, além dos efeitos colaterais como vômitos, náusea e dor, causados pela terapia utilizada no tratamento 24 , como evidenciou os achados deste estudo.…”

Nutritional Assessment, Diagnosis, and Treatment in Geriatrics

“…The study showed that serum albumin and prealbumin levels were maintained even at a marked weight loss, and they were only lowered during extreme hunger -that is, at a BMI below 11 [30,31]. Many other blood markers have been tested, but none have been shown to be adequately sensitive to nutritional status to be used as stand-alone malnutrition markers [32,33]. We would not recommend testing albumin or other blood markers for our case study, as these are likely to be influenced by the acute phase response due to her active infections.…”