Nutritional Risk Factors in Planned Oncologic Surgery: Clinical and Biological Parameters Should Be Routinely What Used?

被引:53
作者
Antoun, Sami [1 ]
Rey, Annie [2 ]
Beal, Jacqueline [3 ]
Montange, Fabienne [3 ]
Pressoir, Martine [3 ]
Vasson, Marie-Paule [3 ]
Dupoiron, Denis [3 ]
Gourdiat-Borye, Anne [3 ]
Guillaume, Alain [3 ]
Maget, Brigitte [3 ]
Nitenberg, Gerard [3 ]
Raynard, Bruno [3 ]
Bachmann, Patrick [3 ]
机构
[1] Inst Gustave Roussy, CLAN, Inter CLAN Ctr Rech Lutte Canc, F-94805 Villejuif, France
[2] Inst Gustave Roussy, Dept Biostat, F-94805 Villejuif, France
[3] Inter CLAN Ctr Rech Lutte Canc, Paris, France
关键词
PERIOPERATIVE ARTIFICIAL NUTRITION; ELECTIVE ADULT SURGERY; TOTAL PARENTERAL-NUTRITION; MALNOURISHED SURGICAL PATIENTS; GASTROINTESTINAL CANCER; WEIGHT-LOSS; TRIAL; CHEMOTHERAPY; MORBIDITY; MORTALITY;
D O I
10.1007/s00268-009-0033-3
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background Screening for malnutrition is recommended in hospitalized and planned surgical patients. The aim of this study was to analyze the feasibility and routine prognostic value Of using the principal recommended nutritional screening and evaluation tools for cancer patients undergoing major Surgery. Methods This study is a prospective, 3-month, multicenter observational trial recording weight loss, body mass index, albumin, transthyretin, and PG-SGA. The morbidity rate wits assessed on the basis of major complications (MC), whether of in infectious (MIC) or noninfectious (MNIC) nature. Results Two hundred seventy-five patients were recruited at nine centers. The following percentages were recorded with respect to morbidity: 28.4% MC, 12.7% MIC, and 22.2% MNIC. Univariate analysis revealed a statistical association only between weight loss greater than 10% and MIC and hospital stay. A weight loss of 15% is required to demonstrate an association with either MC, MIC, or MNIC. Body mass index (BMI) was associated only with MNIC, PG-SGA with MC. and albumin <30 g/l was strongly associated with all types of morbidity (MC, MIC MNIC. Multivariate analysis indicated that only albumin <30 g/l and an operating time of more than 4 It are significantly associated with morbidity. Conclusions III this Study, the best nutritional factor for detecting the risk of MC is albumin levels below 30 g/l A weight loss greater than 15% is required to obtain it statistically significant correlation with the existence of MC.
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收藏
页码:1633 / 1640
页数:8
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