Malnutrition risk predicts surgical outcomes in patients undergoing gastrointestinal operations: Results of a prospective study

Summary Background & aims Patients undergoing gastrointestinal operations are at risk of malnutrition which may increase the chance of adverse surgical outcomes. This prospective study aimed at correlating nutritional status of patients having gastrointestinal operations with their short-term su...

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Published in:	Clinical nutrition (Edinburgh, Scotland) Vol. 34; no. 4; pp. 679 - 684
Main Authors:	Ho, Judy W.C, Wu, Arthur H.W, Lee, Michelle W.K, Lau, So-ying, Lam, Pui-shan, Lau, Wai-shan, Kwok, Sam S.S, Kwan, Rosa Y.H, Lam, Cheuk-fan, Tam, Chun-kit, Lee, Suk-on
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-08-2015
Subjects:	Aged Aged, 80 and over Asian Continental Ancestry Group Body Mass Index Digestive System Surgical Procedures - adverse effects Elective Surgical Procedures Female Gastroenterology and Hepatology Gastrointestinal surgery Hong Kong - epidemiology Hospital Mortality Humans Length of Stay Logistic Models Male Malnutrition Malnutrition - epidemiology Middle Aged Morbidity Mortality Multivariate Analysis Nutrition Assessment Nutritional screening Nutritional Status Postoperative Complications - diagnosis Postoperative Complications - epidemiology Postoperative Complications - etiology Preoperative Period Prospective Studies Risk Factors Surgical outcomes Treatment Outcome Hong Kong Surgical outcomes American Society of Anesthesiologist national surgical quality improvement program ASA Chinese version of malnutrition universal screening tool BAPEN Malnutrition Nutritional screening Length of stay BMI C-MUST GI British Association of Parenteral and Enteral Nutrition malnutrition universal screening tool Mortality body mass index length of hospital stay VA MUST surgical outcomes monitoring and improvement program SOMIP gastrointestinal LOS veterans affairs NSQI Gastrointestinal surgery
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Summary:	Summary Background & aims Patients undergoing gastrointestinal operations are at risk of malnutrition which may increase the chance of adverse surgical outcomes. This prospective study aimed at correlating nutritional status of patients having gastrointestinal operations with their short-term surgical outcomes captured by a territory-wide Surgical Outcomes Monitoring and Improvement Program. Methods The preoperative malnutrition risk of Chinese adult patients undergoing elective/emergency ultra-major/major gastrointestinal operations in two surgical departments over a 12-month period were assessed by Chinese version of Malnutrition Universal Screening Tool. Their perioperative risk factors and clinical outcomes, including length of hospital stay, mortality and morbidity, were retrieved from the above mentioned program. Correlation of malnutrition risk with clinical outcomes was assessed by logistic regression analysis after controlling for known confounders. Results 943 patients (58% male; mean age 65.9 ± 14.8 years) underwent gastrointestinal operations (40.3% emergency operation; 52.7% ultra-major procedures; 66.9% bowel resections) had analyzable data. 15.8% and 17.1% of patients were at medium and high risk of malnutrition, respectively. Malnutrition risk score according to the screening tool was an independent predictor of length of hospital stay, 30-day mortality, 60-day mortality and minor medical complications. Similar correlations were found for various sub-scores of malnutrition risk. Weight loss sub-score was predictive of 30-day mortality, 60-day mortality and minor medical complications. Body mass index was predictive of mortality (30- and 60- day) whereas the acute disease sub-score was predictive of length of hospital stay. Conclusions Preoperative malnutrition was an important predictor of poor clinical outcomes in patients undergoing gastrointestinal operations in Hong Kong.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0261-5614 1532-1983
DOI:	10.1016/j.clnu.2014.07.012