Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease

Rocha, Raquel; Santos, Geisa de Jesus; Santana, Genoile Oliveira

doi:10.4292/wjgpt.v12.i5.90

Cited by 4 publications

(5 citation statements)

References 88 publications

(95 reference statements)

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“…According to the literature, age, emergency surgery, previous surgery, comorbidities, anemia, and fever are related to increased incidence of postoperative complications in patients following surgery for UC [12,13,[27][28][29][30][31]. In our study, no such relationships were found with regard to anemia, previous surgery, and fever, while type of the surgery and older age significantly increased the risk of complications.…”

Section: Discussioncontrasting

confidence: 55%

Surgical Outcomes in 62 Patients with Ulcerative Colitis: A Retrospective, Single-Center Study from Poland

et al. 2023

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Background:Surgery continues to play an important role in the treatment of ulcerative colitis (UC), which is one of the most common inflammatory diseases of the colon and rectum. This retrospective study from a single center in Poland aimed to evaluate surgical outcomes in 62 patients with ulcerative colitis. Material/Methods: The study enrolled 62 patients (36 men [58.1%], 26 women [41.9%]), mean age 52.69±16.84 (range, 19-96) years who underwent surgical treatment of UC during the period 2001-2020. The mandatory inclusion criteria were patients with UC, who underwent total intra-abdominal colectomy (n=22, 46.8%), proctocolectomy (n=25, 53.2%), or left-sided hemicolectomy (n=8, 12.9%). The primary endpoint was postoperative death, and secondary endpoints were long hospitalization (>15 days), complications, and relaparotomy. Results: Postoperative mortality was observed in 8 (12.9%) patients. Older age and low albumin level were associated with longer hospitalization time (P=0.004 and P<0.001, respectively). High C-reactive protein (CRP) level (P=0.003), high CRP/albumin ratio (P=0.023), and malnourishment (P=0.026) were risk factors for complications. Malnutrition (P=0.026), older age (P=0.031), high CRP level (p<0.001), high CRP/albumin ratio (P=0.014), arterial hypertension (P=0.012), and urgent surgeries (P=0.021) were associated with higher risk of postoperative death. Patients who had undergone previous surgeries were more likely to need relaparotomy (P=0.022). Conclusions:Preoperative nutritional status was an important factor associated with postoperative outcomes in patients with ulcerative colitis. Correction of malnutrition seems to be a vital part of preoperative preparation.

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Section: Discussioncontrasting

confidence: 55%

Surgical Outcomes in 62 Patients with Ulcerative Colitis: A Retrospective, Single-Center Study from Poland

et al. 2023

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“…Various nutritional markers have been assessed preoperatively to predict the risks of complications after UC surgery [10][11][12]. They are expected to accurately reflect the preoperative status of the patient and are important in the risk-benefit analysis of surgery.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Nutritional Index is a Predictive Marker for Postoperative Complications in Patients with Late‐Onset Ulcerative Colitis

et al. 2023

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Purpose The number of patients with late-onset ulcerative colitis (UC) requiring surgery has increased in recent years. The risk of postoperative complications is higher in the elderly, so preoperative assessment is important. We aimed to explore the performance of preoperative assessment of nutritional markers for predicting postoperative complications in patients with late-onset UC. Methods We retrospectively analysed 140 medically refractory UC patients who underwent surgery. The association between age at UC onset and risk of postoperative complications was explored using a fractional polynomial model. Uni-and multi-variate logistic regression analyses were performed to identify nutritional markers associated with postoperative complications. Results The polynomial model showed patients with UC onset after 50 years of age had an increased risk of postoperative complications. Late-onset (LO) UC, an onset occurring after 50 years old, was associated with a higher risk of incisional surgical site infection (SSI) and intra-abdominal abscess than early-onset (EO) UC. Compared with the EO group, the LO group had fewer nutritional markers that were significantly associated with postoperative complications. The prognostic nutritional index (PNI) was calculated using the albumin level and the total lymphocyte count, and it was the only index that was significant in the LO group (odds ratio 0.872 95% CI 0.77-0.99, P = 0.03). Conclusions It was more difficult to use nutritional status to predict the risk of postoperative complications in patients with late-onset UC than in patients with early-onset ulcerative colitis. PNI may be a useful nutritional marker for patients with both late-and early-onset UC.

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“…Malnutrition is a risk factor for postoperative complications. 59 Early administration of EEN and PN should be considered at least 7 days prior to surgery in patients with malnutrition undergoing surgery if diet is anticipated to be met with poor tolerance or not consumed in sufficient amounts to meet >50% of estimated nutrition needs. Although EEN or PEN is generally preferred over PN for nutrition support in the preoperative period when the gastrointestinal tract is functional, there are cases in which EEN or PEN are contraindicated and PN must be used (Table 3).…”

Section: Perioperative Nutrition Considerations For Surgerymentioning

confidence: 99%

“…Malnutrition is a risk factor for postoperative complications 59 . Early administration of EEN and PN should be considered at least 7 days prior to surgery in patients with malnutrition undergoing surgery if diet is anticipated to be met with poor tolerance or not consumed in sufficient amounts to meet >50% of estimated nutrition needs.…”

Section: Perioperative Nutrition Considerations For Surgerymentioning

confidence: 99%

Use of oral diet and nutrition support in management of stricturing and fistulizing Crohn's disease

Fansiwala,

Shah,

McNulty

et al. 2023

Nut in Clin Prac

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Crohn's disease (CD), a form of inflammatory bowel disease, involves chronic inflammation within the gastrointestinal tract. Intestinal strictures and fistulas are common complications of CD with varying severity in their presentations. Modifications in oral diet or use of exclusive enteral nutrition (EEN) are common approaches to manage both stricturing and fistulizing disease, although supporting research evidence is generally limited. In the preoperative period, there is strong evidence that EEN can reduce surgical complications. Parenteral nutrition (PN) is often utilized in the management of enterocutaneous fistulas, given that oral diet and EEN may potentially increase output in proximal fistulas. This narrative review highlights the current practices and evidence for the roles of oral diet, EEN, and PN in treatment and management of stricturing and fistulizing CD.

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Influence of nutritional status in the postoperative period of patients with inflammatory bowel disease

Cited by 4 publications

References 88 publications

Surgical Outcomes in 62 Patients with Ulcerative Colitis: A Retrospective, Single-Center Study from Poland

Surgical Outcomes in 62 Patients with Ulcerative Colitis: A Retrospective, Single-Center Study from Poland

The Prognostic Nutritional Index is a Predictive Marker for Postoperative Complications in Patients with Late‐Onset Ulcerative Colitis

Use of oral diet and nutrition support in management of stricturing and fistulizing Crohn's disease

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