Preoperative Nutritional Risk Assessment in Predicting Postoperative Outcome in Patients Undergoing Major Surgery

Kuzu, Mehmet Ayhan; Terzioğlu, Helin; Genç, Volkan; Erkek, Ayhan Bulent; Ozban, Murat; Sonyurek, P.; Elhan, Atilla Halil; Torun, Nusret

doi:10.1007/s00268-005-0163-1

Cited by 170 publications

(103 citation statements)

References 26 publications

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“…However, hypoalbuminemia was the only independent factor for postoperative morbidity after multivariate analysis. Our finding is consistent with those of two large population-based prospective studies in France [7] and the United States [11] . Gibbs et al [11] reported that a decrease in serum albumin from concentrations greater than 46 g/L to less than 21 g/L was associated with an exponential increase in mortality rates from less than 1% to 29% and in morbidity rates from 10% to 65% following non-cardiac surgery.…”

Section: Discussionsupporting

confidence: 82%

“…Albumin has a long halflife of 20 d, so that metabolic effects on its concentration reflect prolonged malnourishment, as in cancer patients. Hypoalbuminemia is widely accepted to be a good indicator for malnutrition in many national cancer studies [7,11,17] . It is remarkable that tumor size, but not the stage, is relevant to hypoalbuminemia.…”

Section: Discussionmentioning

confidence: 99%

“…Serum albumin is a good and simple predictor of surgical risk and has a close correlation with the degree of malnutrition [4] . Hypoalbuminemia is a predictor of delayed recovery of bowel function and is strongly associated with postoperative complications after right hemicolectomy for right-sided colon cancer [5] , or following other major gastrointestinal surgery [6][7][8] . However, there is little information regarding the effect of hypoalbuminemia on the development of postoperative complications after rectal cancer surgery, and the results remain controversial [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

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Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

Lohsiriwat¹,

Lohsiriwat²,

Boonnuch³

et al. 2008

WJG

120

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AIM:To determine the relationship between preoperative hypoalbuminemia and the development of complications following rectal cancer surgery, as well as postoperative bowel function and hospital stay. METHODS:The medical records of 244 patients undergoing elective oncological resection for rectal adenocarcinoma at Siriraj Hospital during 2003 and 2006 were reviewed. The patients had pre-operative serum albumin assessment. Albumin less than 35 g/L was recognized as hypoalbuminemia. Postoperative outcomes, including mortality, complications, time to first bowel movement, time to first defecation, time to resumption of normal diet and length of hospital stay, were analyzed. RESULTS:The patients were 139 males (57%) and 105 females (43%) with mean age of 62 years. Fifty-six patients (23%) had hypoalbuminemia. Hypoalbuminemic patients had a significantly larger tumor size and lower body mass index compared with non-hypoalbuminemic patients (5.5 vs 4.3 cm; P < 0.001 and 21.9 vs 23.2 kg/m 2 ; P = 0.02, respectively). Thirty day postoperative mortality was 1.2%. Overall complication rate was 25%. Hypoalbuminemic patients had a significantly higher rate of postoperative complications (37.5% vs 21.3%; P = 0.014). In univariate analysis, hypoalbuminemia and ASA status were two risk factors for postoperative complications. In multivariate analysis, hypoalbuminemia was the only significant risk factor (odds ratio 2.22, 95% CI 1.17-4.23; P < 0.015). Hospitalization in hypoalbuminemic patients was significantly longer than that in non-hypoalbuminemic patients (13 vs 10 d, P = 0.034), but the parameters of postoperative bowel function were not significantly different between the two groups. CONCLUSION:Pre-operative hypoalbuminemia is an independent risk factor for postoperative complications following rectal cancer surgery.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

Lohsiriwat¹,

Lohsiriwat²,

Boonnuch³

et al. 2008

WJG

120

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“…A MNA-SF ainda é considerada padrão ouro para avaliação de idosos 29 , grupo para o qual foi desenvolvida, enquanto que a NRS 2002 tem grande potencial em cenário hospitalar, já que foi desenvolvida especificamente para pacientes nessa condição e com necessidade de suporte nutricional 30 .…”

Section: I S C U S S ã Ounclassified

Aplicabilidade dos métodos de triagem nutricional no paciente hospitalizado

et al. 2008

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A prevalência de desnutrição energético-protéica em ambiente hospitalar varia de 20% a 50%, conforme critérios utilizados. O risco nutricional se refere ao risco aumentado de morbimortalidade em decorrência do estado nutricional. A triagem nutricional identifica indivíduos desnutridos ou em risco de desnutrição, almejando determinar se existe risco nutricional e se é necessária avaliação nutricional mais detalhada. Já a avaliação nutricional, além de detectar desnutrição, classifica seu grau e permite coleta de informações que auxiliem em sua correção. Foram revisadas as ferramentas de triagem nutricional mais citadas na literatura atual. Para obtenção dos artigos de triagem nutricional foram feitas pesquisas nos websites científicos. Dentre as ferramentas citadas, ressalta-se a Nutritional Risk Screening 2002, que pode ser aplicada a todos os pacientes internados em hospitais, independentemente da doença que apresentem ou da idade, sem custo adicional ao serviço e que pode ser efetuada por diferentes profissionais. Cabe a cada profissional desenvolver senso crítico para determinar sua técnica de preferência. Termos de indexação:Assistência hospitalar. Desnutrição. Programas de rastreamento. Triagem.

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“…A study by Kuzu et al [11] states that any form of nutritional assessment technique based on Clinical and Subjective evaluation showed to improve the outcome of surgical care.…”

Section: Discussionmentioning

confidence: 99%

A prospective study of nutritional status of hospitalised patients in urban corporate set up

et al. 2009

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Malnutrition is quite common in hospitalised patients, with most studies indicating a prevalence of 20-62%. It is associated with length of stay and morbidity in developed countries. This study was performed to identify nutritional status of hospitalised patients in urban corporate setting by using primarily, the Mini Nutritional Assessment tool. This is a prospective study conducted in an urban tertiary care centre. 304 consecutive patients admitted to the hospital were studied, between the dates of July 2007 and September 2007. The study included the measurement of anthropometrics, global evaluation, dietary habits and subjective assessment score. Serum albumin level was used to assess visceral protein status. The study excluded Obstetrics & Gynaecology, paediatric and critical care cases. Out of the 304 patients, Females 41.55% and Male 42.55% were over nourished. Medical patients were more malnourished and at risk of malnutrition (15.08% and 70.85%) when compared to surgical patients (12.38% and 60.95%) respectively. This study shows that in an urban setting, the risk of malnutrition (overweight & underweight) is very real. Clinicians have to note that malnutrition has a direct impact on the outcome of treatment.

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Preoperative Nutritional Risk Assessment in Predicting Postoperative Outcome in Patients Undergoing Major Surgery

Cited by 170 publications

References 26 publications

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

Pre-operative hypoalbuminemia is a major risk factor for postoperative complications following rectal cancer surgery

Aplicabilidade dos métodos de triagem nutricional no paciente hospitalizado

A prospective study of nutritional status of hospitalised patients in urban corporate set up

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