2006, Number 4
Clinical-biochemical evaluation of the nutritional risk in surgical patients
Tapia JJ, Azcoitia MF, López RSC, Lonngi DEH, Melero VA, Cerda CLJ, Arellano RJF, Olmedo CVH, Gracida MN, Cervantes SC, Shapiro SI, Sentíes NF
Full text
Language: Spanish
References: 13
Page: 212-218
PDF size: 91.95 Kb.
ABSTRACT
Objective: To establish whether a simple nutritional evaluation, consisting in a subjective global assessment, can be as reliable as the determination of complex parameters, for predicting the evolution of patients submitted to surgery.Setting: First multicentric study pursued by the Asociación Mexicana de Cirugía General through its Investigation Committee. The study was performed in five hospitals, four public and one private hospital, located in Mexico.
Design: Observational, transversal, prospective, comparative and blind study.
Statistical analysis: Parametric tests for the proportional variables of interval and. Nonparametric tests for the ordinal and nominal variables.
Patients and method: 234 patients subjected to non-malignant major abdominal surgery were studied to whom a subjective global assessment was applied and serum albumin was measured during the 30 days after surgery.
Results: 60.7% were women. The mean age was 42.8 years. Open cholecystecomy was the most frequently performed surgery. From the 234 patients, 72 (30.8%) had initial serum albumin values equal or lower than 3.2 g/dl and 62 (26.5%) scored a B or a C in the subjective global assessment (SGA). From all patients, 17 presented major complications. Time of hospital stay and general complications were larger for the B and C groups. Patients scoring an A in the SGA, serum albumin had a range, mean, and mode larger than the one recorded for patients scoring B or C in their SGA When the SGA variables type A, B, or C and serum albumin lesser or equal to 3.2 g/dl (SGA+A) were analyzed together, they revealed a greater sensitivity and specificity for identifying patients with major complications, rather than when they were considered separately.
Conclusion: The Subjective Global Assessment is a clinical parameter that is cheap, quick and simple to perform, which was shown to be as useful as the serum albumin determination to identify those patients subjected to major abdominal surgery having greater risk of presenting complications, need for another intervention, or requiring a longer hospitalization.
REFERENCES