Nutritional status and its effect on complications in patients with colorectal cancer
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Wien Klin Wochenschr https://doi.org/10.1007/s00508-020-01671-4
Nutritional status and its effect on complications in patients with colorectal cancer Maja Karin
· Ante Bogut · Iva Hojsak · Emil Babic´ · Mile Volaric´ · Milenko Bevanda
Received: 14 February 2020 / Accepted: 29 April 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020
Summary Background Nutritional status is an important factor for predicting the risk of developing complications after a surgical procedure. Many nutritional assessments are used in clinical practice, but their role in predicting postoperative outcomes is unknown. Therefore, the aim of this study was to assess the utility of nutritional risk factors at the diagnosis of colorectal cancer (CRC) for predicting early postsurgical complications. Methods This was a prospective observational study including 127 patients with CRC at diagnosis. Their preoperative nutritional status was analyzed by body mass index (BMI), triceps and subscapular skinfolds and two nutritional scales: the Patient-Generated Subjective Global Assessment (PG-SGA) and the Malnutrition Universal Screening Tool (MUST). The outcome variables, including postoperative complications, length of hospital stay and mortality, were analyzed. Results Patients identified as malnourished by PGSGA score had prolonged hospital stays (p = 0.01). The risk of infection was increased in older patients (hazard ratio, HR 1.12; 95% confidence interval, CI 1.04–1.21) but was not associated with nutritional status. Early wound dehiscence was increased in patients with higher BMI (HR 1.15; 95% CI 1.01–1.29), with higher subscapular skinfold thickness and increased age (HR 1.05; 95% CI 1.05–1.10). PostoperM. Karin () · A. Bogut · E. Babi´c · M. Volari´c · M. Bevanda Department of Gastroenterology and Hepatology, University Clinical Hospital Mostar, Bijeli Brijeg bb, Mostar, Bosnia and Herzegovina [email protected] I. Hojsak Referral center for pediatric gastroenetrology and nutrition, Children’s Hospital Zagreb, Klai´ceva 16, Zagreb, Croatia
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ative mortality was not significantly associated with nutritional status. Conclusion Malnourished patients, as identified by the PG-SGA score, stayed longer in hospital than patients who were not malnourished, while increased BMI was recognized as a risk factor for wound dehiscence. Keywords Nutritional assesment · Patient-Generated Subjective Global Assesment · Malnutrition Universal Screening Tool · Length of hospital stay · Postoperative mortality
Introduction Colorectal cancer (CRC) is a significant global problem in terms of both the annual incidence, which has been increasing, and the complications that the disease carries. Patients with CRC have various physiological and psychological problems, which can ultimately lead to malnutrition in 29–60% of patients [1–3]. The prevalence of malnutrition in newly diagnosed patients with CRC depends on the nutritional tools used and the stage of the disease [4]. Malnutrition is the result of several factors, including the effects of th
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