Nutritional assessment methods as predictors of postoperative mortality in gastric cancer patients submitted to gastrectomy

Abstract

Objectives: to determine the nutritional evaluation method that best predicts mortality in 90 days of patients submitted to gastrectomy for gastric cancer. Methods: we conducted a prospective study with 44 patients with gastric cancer, stages II to IIIa, of whom nine were submitted to partial gastrectomy, 34 to total gastrectomy, and one to esophago-gastrectomy. All patients were nutritionally evaluated through the same protocol, up to 72h after hospital admission. The parameters used were Patient-Generated Subjective Global Assessment (PGSGA), classical anthropometry, current weight and height, percentage of weight loss (%WL) and body mass index (BMI). We also measured the thickness of the thumb adductor muscle (TAM) in both hands, dominant hand (TAMD) and non-dominant hand (TAMND), as well as the calculated the prognostic nutritional index (PNI). The laboratory profile included serum levels of albumin, erythrocytes, hemoglobin, hematocrit, leukocytes, and total lymphocytes count (TLC). Results: of the 44 patients studied, 29 (66%) were malnourished by the subjective method, 15 being grade A, 18 grade B and 11 grade C. Cases with PGSGA grade B and TAMD 10.2±2.9 mm were significantly associated with higher mortality. The ROC curves (95% confidence interval) of both PGSGA and TAMD thickness reliably predicted mortality at 30 and 90 days. No laboratory method allowed predicting mortality at 90 days. Conclusion: PGSGA and the TAMD thickness can be used as preoperative parameters for risk of death in patients undergoing gastrectomy for gastric cancer.

Enteral nutrition provides favorable postoperative outcomes for patients with pseudomyxoma peritonei: a retrospective study

“…Moreover, our study suggested that EN might improve the long-term prognosis of PMP patients, as the univariate and multivariate analyses showed that EN was an independent protective factor both for hospital stay time and complications. These findings were consistent with previous studies in that favorable nutritional status brought by EN was a positive predictor for postoperative mortality and prognosis in cancer patients (30,31). The improvement of nutritional status by EN also shortened the hospital stay time in this study, which saves on hospitalization costs and is beneficial to the physical and mental health of PMP patients.…”

Comparison of gastric-jejunum pouch anastomosis and Billroth-II reconstructions after distal gastrectomy: a propensity score matching analysis

“…We evaluated the endoscopic changes of the residual stomach according to the RGB (residue, gastritis, and bile) grading system [ 9 ]. Furthermore, we used the Visick grading method to assess the postoperative subjective feelings and postoperative nutritional status of the patients in the 2 groups [ 10 ]. All patients were reexamined 1 year after the operation.…”