Pp146-Mon Determinants of Malnutrition and Postoperative Complications in Hospitalized Surgical Patients

Leandro‐Merhi, Vânia Aparecida; Aquino, José Luiz Braga de

doi:10.1016/s0261-5614(13)60457-4

Cited by 23 publications

(25 citation statements)

References 24 publications

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“…The findings from this study support the association between malnutrition and adverse surgical outcomes in non‐upper gastrointestinal cancer cases . Given that nearly one in 10 patients possessed at least one marker of poor nutrition, it suggests that malnutrition is a considerable issue amongst patients undergoing major cancer surgery.…”

Section: Discussionsupporting

confidence: 72%

“…The difference in Clavien III–V complications between the two groups were compared between those meeting the definition of being malnourished and those who do not. Subgroup analysis, including repeating the matching process, was performed on upper gastrointestinal cases that have been described to potentiate malnutrition (esophagectomy, gastrectomy and pancreatectomy) compared to the remaining procedures …”

Section: Methodsmentioning

confidence: 99%

“…It is estimated that approximately 31% of all individuals admitted to a hospital for any cause are malnourished, with cancer patients experiencing even higher rates due to the systemic nature of malignancy . Malnutrition has a multitude of clinical implications having been demonstrated to adversely affect mortality, morbidity and length of hospital stay amongst heterogeneous populations of surgical patients . However, there is considerable disparity in the assessment of malnutrition.…”

Section: Introductionmentioning

confidence: 99%

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Adverse impact of malnutrition markers on major abdominopelvic cancer surgery

Sathianathen

Kwaan

Lawrentschuk

et al. 2019

ANZ Journal of Surgery

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Background: Malnutrition has been associated with adverse postoperative outcomes in a range of procedures but none have evaluated the interaction between clinical indicators of malnutrition. We aimed to comparatively evaluate how combinations of nutritional parameters impact postoperative outcomes amongst patients undergoing major cancer operations. Methods: Major abdominopelvic cancer surgery cases (colectomy, cystectomy, esophagectomy, gastrectomy, hysterectomy, nephrectomy, pancreatectomy, pneumonectomy and prostatectomy) were identified in the American College of Surgeons National Surgical Quality Improvement Program database from 2007-2016. Malnutrition was defined by the presence of the following parameters: body mass index <18.5 kg/m 2 ; preoperative serum albumin <3.0 g/dL or more than 10% weight loss in the last 6 months. Malnourished cases were matched with cases with satisfactory nutritional status using propensity scores. The primary outcome was the incidence of Clavien III-IV complications. Results: Of the 30 207 cases included, 8.5% had at least one marker of malnutrition. The incidence of Clavien III-IV complications across all cases was 5.8%. In the matched cohort, malnourished cases had a higher rate of complications than those with adequate nutritional status (11.3% versus 9.6%, P = 0.018). A correlation was observed between the number of malnutrition markers possessed and the incidence of Clavien III-V complications. Cases with all three makers had the highest likelihood of experiencing a complication (odds ratio 5.47, 95% confidence interval 1.85-16.17). Conclusion: Poor nutritional status confers an increased risk of major postoperative complications and being discharged to a facility in non-upper gastrointestinal cancer patients. There was a correlation between the number of malnutrition parameters and the risk of complications.

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Section: Discussionsupporting

confidence: 72%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Adverse impact of malnutrition markers on major abdominopelvic cancer surgery

Sathianathen

Kwaan

Lawrentschuk

et al. 2019

ANZ Journal of Surgery

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“…Post‐operative complications that are influenced by nutrition include pneumonia, surgical site infections and anastomosis leak. This has been confirmed by studies conducted in LMICs, also including trauma victims, which consistently showed poor outcomes among patients with malnutrition or at risk of malnutrition (Table ) . Furthermore, malnutrition is also associated with increased toxicity of, decreased response to, and poor outcomes of chemotherapy and radiotherapy, which are sometimes required to treat patients with cancer in addition to or instead of surgical intervention .…”

Section: Resultsmentioning

confidence: 65%

“…Reports have indicated that the prevalence of hospital malnutrition is as high as 50% in HICs and approximately 70% in LMICs . Studies in LMICs show that the prevalence of pre‐operative malnutrition among surgical patients is also high (Table ) . Of these studies, 16 were from Latin American countries, 7 from China, 3 from Vietnam, 3 from Turkey, 2 from India and 1 from Thailand.…”

Section: Resultsmentioning

confidence: 99%

Perioperative nutrition management as an important component of surgical capacity in low‐ and middle‐income countries

Nakahara

Nguyen

Bui

et al. 2017

Tropical Med Int Health

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SummaryNeeds for surgical care are growing in low-and middle-income countries. Existing surgical care capacity indicators, focusing on the availability of equipment, personnel, and operation and anaesthetic skills, are not intended to evaluate perioperative nutrition management, which influences surgical outcomes. In this narrative review, we describe the prevalence of malnutrition and its clinical consequences among surgical patients in low-and middle-income countries, suggest potential measures to improve nutrition management and discuss the necessity of considering nutrition management as a component of surgical care capacity.

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Determining the Optimal Quantitative Threshold for Preoperative Albumin Level Before Elective Colorectal Surgery

Bendersky

Sun

Adam

et al. 2017

Journal of Gastrointestinal Surgery

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This study objectively determines that a threshold preoperative serum albumin of ≥3.9 mg/dL is associated with improved outcomes in elective colorectal surgery patients. Each 0.5 mg/dL decrease in albumin was progressively associated with increased risk for complications. Identifying a minimum albumin threshold has implications in perioperative optimization of patients undergoing colorectal surgery.

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Pp146-Mon Determinants of Malnutrition and Postoperative Complications in Hospitalized Surgical Patients

Cited by 23 publications

References 24 publications

Adverse impact of malnutrition markers on major abdominopelvic cancer surgery

Adverse impact of malnutrition markers on major abdominopelvic cancer surgery

Perioperative nutrition management as an important component of surgical capacity in low‐ and middle‐income countries

Determining the Optimal Quantitative Threshold for Preoperative Albumin Level Before Elective Colorectal Surgery

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