Jagoe R T, Goodship T H, Gibson G J
Department of Respiratory Medicine, Freeman Hospital, Newcastle upon Tyne, United Kingdom.
Ann Thorac Surg. 2001 Mar;71(3):929-35. doi: 10.1016/s0003-4975(00)02005-1.
Patients referred for lung cancer operations were reported to be nutritionally depleted. This may be relevant in determining patient outcome after surgical procedures. A study was undertaken to measure a range of nutritional variables including dietary intake of patients referred to a regional cardiothoracic center for curative lung cancer operations.
Anthropometric measurements, grip strength, fat-free mass (FFM), serum protein concentrations, lymphocyte count, creatinine-height index, subjective global assessment, and data on daily intakes of energy, protein, and vitamin C were collected prospectively. Anthropometric indices were also measured in a group of control patients with mild chronic obstructive pulmonary disease.
Sixty patients and 22 control patients were recruited. Weight, skin-fold thickness, and grip strength were not significantly different between patients and control patients, and both groups were similar to the general population. However, 8 patients (13.3%) had a body mass index (BMI) less than 20, and 14 patients (24.1%) had a fat-free mass index less than 15. Serum albumin and transferrin concentrations and lymphocyte count were very rarely depressed but prealbumin and retinol-binding protein levels were below normal in 11.9% and 8.3% of patients, respectively. Thirty percent of patients reported low energy intake, 13% reported a low protein intake, and 61.7% had reduced vitamin C intake.
Severe nutritional depletion was uncommon in patients referred for operations for lung cancer and its frequency may have been overestimated in some previous reports. A low intake of vitamin C was common in our patients but its clinical significance is unclear.
