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Preoperative malnutrition assessments as predictors of postoperative mortality and morbidity in colorectal cancer: an analysis of ACS-NSQIP.

Hu WH, Cajas-Monson LC, Eisenstein S, Parry L, Cosman B, Ramamoorthy S - Nutr J (2015)

Bottom Line: Only hypoalbuminemia significantly predicted all postoperative complications, even in further multivariate logistic regression analyses (p < 0.001).Multiple regression analysis showed that the hypoalbuminemia group had the highest coefficient in significant association with length of total hospital stay (B = 3.585, p < 0.001) and overall complication (B = 0.119, p < 0.001).Hypoalbuminemia, with levels below 3.5 g/dl, serves as an excellent assessment tool and preoperative predictor of postoperative outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, School of Medicine, University of California, San Diego Health System, La Jolla, CA, USA. gary.hu0805@msa.hinet.net.

ABSTRACT

Background: Nutritional status is an important factor in predicting the risk associated with surgery for cancer patients. This is especially true in colorectal cancer. Many nutritional assessments are used in clinical practice, but those assessments are rarely evaluated for their ability to predict postoperative outcome.

Methods: This is a retrospective, multi-institutional study of the ACS-NSQIP database, investigating preoperative nutrition status and its association with postoperative mortality and morbidity.

Results: The prevalence of malnutrition is higher in colorectal cancer, when compared with other most common cancers. Among 42,483 colorectal cancer patients postoperative mortality was significantly associated with hypoalbuminemia (hazard ratio = 3.064, p < 0.001), body weight loss (hazard ratio = 1.229, p = 0.033) and body mass index of <18.5 kg/m(2) (hazard ratio = 1.797, p < 0.001). Only hypoalbuminemia significantly predicted all postoperative complications, even in further multivariate logistic regression analyses (p < 0.001). Multiple regression analysis showed that the hypoalbuminemia group had the highest coefficient in significant association with length of total hospital stay (B = 3.585, p < 0.001) and overall complication (B = 0.119, p < 0.001).

Conclusions: In colorectal cancer, malnutrition significantly contributes to postoperative mortality, morbidity and length of total hospital stay. Hypoalbuminemia, with levels below 3.5 g/dl, serves as an excellent assessment tool and preoperative predictor of postoperative outcomes.

No MeSH data available.


Related in: MedlinePlus

Malnutrition rate was demonstrated with serum albumin, body weight loss and body mass index criteria. a Comparison of malnutrition rate in most common cancers; b Annular malnutrition rate in colorectal cancer, 2009–2013. BWL, body weight loss; BMI, body mass index
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Fig1: Malnutrition rate was demonstrated with serum albumin, body weight loss and body mass index criteria. a Comparison of malnutrition rate in most common cancers; b Annular malnutrition rate in colorectal cancer, 2009–2013. BWL, body weight loss; BMI, body mass index

Mentions: When using the hypoalbuminemia criterion of serum albumin levels less than 3.5 g/dl, the prevalence of malnutrition in most common cancers ranged from 4 to 28 %, which was higher than the rates of malnutrition computed by body weight loss or underweight BMI status. Malnutrition was more prevalent in colorectal cancer than in other common cancers (Fig. 1a). The annual malnutrition rate in colorectal cancer decreased gradually from 2010 to 2013 (Fig. 1b).Fig. 1


Preoperative malnutrition assessments as predictors of postoperative mortality and morbidity in colorectal cancer: an analysis of ACS-NSQIP.

Hu WH, Cajas-Monson LC, Eisenstein S, Parry L, Cosman B, Ramamoorthy S - Nutr J (2015)

Malnutrition rate was demonstrated with serum albumin, body weight loss and body mass index criteria. a Comparison of malnutrition rate in most common cancers; b Annular malnutrition rate in colorectal cancer, 2009–2013. BWL, body weight loss; BMI, body mass index
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4561437&req=5

Fig1: Malnutrition rate was demonstrated with serum albumin, body weight loss and body mass index criteria. a Comparison of malnutrition rate in most common cancers; b Annular malnutrition rate in colorectal cancer, 2009–2013. BWL, body weight loss; BMI, body mass index
Mentions: When using the hypoalbuminemia criterion of serum albumin levels less than 3.5 g/dl, the prevalence of malnutrition in most common cancers ranged from 4 to 28 %, which was higher than the rates of malnutrition computed by body weight loss or underweight BMI status. Malnutrition was more prevalent in colorectal cancer than in other common cancers (Fig. 1a). The annual malnutrition rate in colorectal cancer decreased gradually from 2010 to 2013 (Fig. 1b).Fig. 1

Bottom Line: Only hypoalbuminemia significantly predicted all postoperative complications, even in further multivariate logistic regression analyses (p < 0.001).Multiple regression analysis showed that the hypoalbuminemia group had the highest coefficient in significant association with length of total hospital stay (B = 3.585, p < 0.001) and overall complication (B = 0.119, p < 0.001).Hypoalbuminemia, with levels below 3.5 g/dl, serves as an excellent assessment tool and preoperative predictor of postoperative outcomes.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, School of Medicine, University of California, San Diego Health System, La Jolla, CA, USA. gary.hu0805@msa.hinet.net.

ABSTRACT

Background: Nutritional status is an important factor in predicting the risk associated with surgery for cancer patients. This is especially true in colorectal cancer. Many nutritional assessments are used in clinical practice, but those assessments are rarely evaluated for their ability to predict postoperative outcome.

Methods: This is a retrospective, multi-institutional study of the ACS-NSQIP database, investigating preoperative nutrition status and its association with postoperative mortality and morbidity.

Results: The prevalence of malnutrition is higher in colorectal cancer, when compared with other most common cancers. Among 42,483 colorectal cancer patients postoperative mortality was significantly associated with hypoalbuminemia (hazard ratio = 3.064, p < 0.001), body weight loss (hazard ratio = 1.229, p = 0.033) and body mass index of <18.5 kg/m(2) (hazard ratio = 1.797, p < 0.001). Only hypoalbuminemia significantly predicted all postoperative complications, even in further multivariate logistic regression analyses (p < 0.001). Multiple regression analysis showed that the hypoalbuminemia group had the highest coefficient in significant association with length of total hospital stay (B = 3.585, p < 0.001) and overall complication (B = 0.119, p < 0.001).

Conclusions: In colorectal cancer, malnutrition significantly contributes to postoperative mortality, morbidity and length of total hospital stay. Hypoalbuminemia, with levels below 3.5 g/dl, serves as an excellent assessment tool and preoperative predictor of postoperative outcomes.

No MeSH data available.


Related in: MedlinePlus