Impact of Malnutrition on Gastrointestinal Surgical Patients

The accurate diagnosis of malnutrition is imperative if we are to impact outcomes in the malnourished. The American Society of Parenteral and Enteral Nutrition (A.S.P.E.N) and Academy of Nutrition and Dietetics (A.N.D), in an attempt to address this issue have provided evidenced-based criteria to di...

Full description

Saved in:
Bibliographic Details
Published in:The Journal of surgical research 2016-09, Vol.205 (1), p.95-101
Main Authors: Mosquera, Catalina, Koutlas, Nicholas J, Lee, Kimberly C, Strickland, Ashley, Vohra, Nasreen A, Zervos, Emmanuel E, Fitzgerald, Timothy L
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Digestive System Surgical Procedures - adverse effects
Digestive System Surgical Procedures - economics
Digestive System Surgical Procedures - mortality
Female
Hospital Costs
Humans
Length of Stay
Male
Malnutrition
Malnutrition - complications
Middle Aged
North Carolina - epidemiology
Nutritional assessment
Postoperative Complications - etiology
Postoperative Complications - mortality
Preoperative evaluation
Retrospective Studies
Surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The accurate diagnosis of malnutrition is imperative if we are to impact outcomes in the malnourished. The American Society of Parenteral and Enteral Nutrition (A.S.P.E.N) and Academy of Nutrition and Dietetics (A.N.D), in an attempt to address this issue have provided evidenced-based criteria to diagnose malnutrition. The purpose of this study was to validate the ASPEN/AND criteria in a cohort of patients from a single high-volume surgical oncology unit. Methods Patients undergoing major abdominal surgery from June 2013 to March 2015 were classified by their nutritional status utilizing the A.S.P.E.N/A.N.D criteria. Results A total of 490 patients were included. Median age was 64 years, a majority were female (50.6%), white (60.2%), underwent elective procedures (77.6%), had a Charlson comorbidity score (CCS) of 3-5 (40.0%), and a Clavien-Dindo complication grade of 0-II (81.2%). A total of 93 (19.0%) patients were classified as moderately/severely malnourished. On univariate analysis, malnourished patients were more likely to be older, undergo emergent procedures, and have a CCS > 5 (p< 0.05). Malnutrition was also associated with a longer post-operative length of stay (LOS), higher cost, higher in-hospital mortality, more severe complications and higher readmission rates (p0.05 failed to reach significance. Conclusion Malnutrition worsens LOS and cost. Utilization of standardized criteria consistently identifies patients at risk of negative outcomes who may benefit from perioperative nutritional support.
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2016.05.030