Department of Global Public Health, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan.
Nutrition. 2018 Apr;48:117-121. doi: 10.1016/j.nut.2017.11.027. Epub 2017 Dec 6.
Nutritional support for surgical care is crucial because hospital malnutrition is rather common. However, low- and middle-income countries have not adequately addressed nutritional management of surgical patients. To highlight need for nutritional management in surgical patients, the present study aimed to describe preoperative nutritional status in patients who underwent gastrointestinal cancer surgery in Vietnam and to investigate the relationship between preoperative malnutrition and adverse outcomes, such as postoperative complications and prolonged length of hospital stay.
We reviewed medical records of patients who underwent a major curative surgery for gastrointestinal cancer at the national hospital in Ho Chi Minh City, Vietnam. We identified preoperative malnutrition based on body mass index and serum albumin level, and postoperative complications in the first 30 d postoperative. We estimated the relative influence of malnutrition on complications and length of hospital stay using multivariate regression models.
Of 459 eligible patients, 63% had colorectal cancer, 33% gastric cancer, and 4% esophageal cancer. The prevalence of malnutrition was 19%. No patients died during hospitalization; however, 26% developed complications after surgery. The average length of hospital stay was 14 d. After controlling for potential confounders, preoperative malnutrition was associated with an increased risk of postoperative complications (odds ratio = 1.97) and prolonged hospital stay (2.8 d).
Preoperative malnutrition affects surgical outcomes among patients with gastrointestinal cancer in Vietnam. We recommend implementing preoperative nutritional interventions to achieve better outcomes among surgical cancer patients.
外科患者的营养支持至关重要,因为医院营养不良较为常见。然而,中低收入国家尚未充分解决外科患者的营养管理问题。为了强调外科患者营养管理的必要性,本研究旨在描述越南胃肠道癌手术患者的术前营养状况,并探讨术前营养不良与术后并发症和住院时间延长等不良结局之间的关系。
我们回顾了越南胡志明市国家医院接受胃肠道癌根治性手术的患者的病历。我们根据体重指数和血清白蛋白水平确定术前营养不良,并在术后 30 天内评估术后并发症。我们使用多变量回归模型估计营养不良对并发症和住院时间的相对影响。
在 459 名符合条件的患者中,63%患有结直肠癌,33%患有胃癌,4%患有食管癌。营养不良的患病率为 19%。没有患者在住院期间死亡,但有 26%的患者在手术后出现并发症。平均住院时间为 14 天。在控制潜在混杂因素后,术前营养不良与术后并发症(优势比=1.97)和住院时间延长(2.8 天)风险增加相关。
术前营养不良影响越南胃肠道癌患者的手术结局。我们建议实施术前营养干预措施,以改善外科癌症患者的结局。