Preoperative Nutritional Assessment by Controlling Nutritional Status (CONUT) is Useful to estimate Postoperative Morbidity After Esophagectomy for Esophageal Cancer

• Published in: World journal of surgery Vol. 40; no. 8; pp. 1910 - 1917
• Main Authors: Yoshida, Naoya, Baba, Yoshifumi, Shigaki, Hironobu, Harada, Kazuto, Iwatsuki, Masaaki, Kurashige, Junji, Sakamoto, Yasuo, Miyamoto, Yuji, Ishimoto, Takatsugu, Kosumi, Keisuke, Tokunaga, Ryuma, Imamura, Yu, Ida, Satoshi, Hiyoshi, Yukiharu, Watanabe, Masayuki, Baba, Hideo
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-08-2016; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Cardiac Surgery; Elective Surgical Procedures - adverse effects; Esophageal Neoplasms - surgery; Esophagectomy - adverse effects; Female; General Surgery; Humans; Incidence; Length of Stay; Lymph Node Excision - adverse effects; Male; Malnutrition - complications; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Esophagectomy; Nutrition Assessment; Nutritional Status; Original Scientific Report; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Preoperative Period; Prognostic Nutritional Index; Retrospective Studies; Risk Factors; Severe Malnutrition; Severity of Illness Index; Surgery; Thoracic Surgery; Total Lymphocyte Count; Transhiatal Esophagectomy; Vascular Surgery; Prognostic Nutritional Index; Severe Malnutrition; Transhiatal Esophagectomy; Minimally Invasive Esophagectomy; Total Lymphocyte Count
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-016-3549-3

Background
A nutritional indicator suitable for predicting complications after esophagectomy has not been confirmed. The nutritional screening tool CONUT is a potential candidate.
Methods
We retrospectively analyzed 352 patients who underwent elective esophagectomy with lymphadenectomy for esophageal cancer between April 2005 and December 2014. Patients were divided into three groups according to the malnutrition degree in controlling nutritional status (CONUT): normal, light malnutrition, moderate or severe malnutrition.
Results
The numbers of patients assigned to the normal, light malnutrition, and moderate or severe malnutrition groups were 205, 126, and 21, respectively. One hundred forty-seven (41.8 %) patients were considered malnourished. Patients with moderate or severe malnutrition had a significantly high incidence of any morbidity, severe morbidities, and surgical site infection. Hospital stay in patients with moderate or severe malnutrition was significantly longer. Logistic regression analysis suggested that moderate or severe malnutrition was an independent risk factor for any morbidity [hazard ratio (HR) 2.75, 95 % confidence interval (CI) 1.081–7.020;
p
 = 0.034] and severe morbidities (HR 3.07, 95 % CI 1.002–9.432;
p
 = 0.049).
Conclusions
CONUT was a convenient and useful tool to assess nutritional status before esophagectomy. Patients with moderate or severe malnutrition according to CONUT are at high risk for postoperative complications.