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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2018, Number 3

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Rev Biomed 2018; 29 (3)

Risk of pre-surgical malnutrition as a causal factor of prolonged hospital stay in gastro intestinal surgery

Peniche-Herrera JR, Cortés-Telles A, Lozano-Salazar RR

Language: Spanish
References: 15
Page: 45-50
PDF size: 231.85 Kb.


ABSTRACT

Introduction. Malnutrition consists of deficit of energy and nutrients. It can contribute to increase the number and severity of complications of the disease. Among surgical procedures, malnutrition its related with nosocomial infections and higher mortality. It has been postulated that an adequate nutritional assessment reduces the risk of developing complications.
Objective. To determine the prevalence of preoperative malnutrition and it’s effects in patients undergoing surgery for gastrointestinal pathology.
Material and methods. This is a clinical observational, descriptive and retrospective chart review of patients who underwent gastrointestinal surgery from January 2016 to December 2016. The association between risk factors and main outcome was analyzed with logistic regression analysis.
Results. Our population consisted of 138 files of patients who underwent gastrointestinal surgery. The prevalence of malnutrition was 4%. The group at risk of preoperative malnutrition had a median hospital length of stay of 5 vs 2 days in the group without risk (p = 0.014). There were non-statistical significant differences in post-surgical complications. Hypoproteinemia is the main serum biomarker related to the existence of preoperative malnutrition (OR 5.91, 95% CI 1.12-31.1, p = 0.036).It was identified that the existence of risk of preoperative malnutrition is related to prolonged hospital stay (OR 1.33, 95% CI 1.07-1.64, p = 0.008)
Conclusions. The evidence of risk of preoperative malnutrition is related to prolonged hospital stay in patients who underwent gastrointestinal surgery. Subsequent studies should focus on nutritional interventions that could shorten hospital length of stay.


REFERENCES

  1. Ocón MJ, Altemir J, Mañas AB, Sallan L, Aguillo E, Gimeno J. Comparación de dos herramientas de cribado nutricional para predecir la aparición de complicaciones en pacientes hospitalizados. Nutr Hosp. 2012 Jun; 27(3): 701-6. DOI: http://dx.doi.org/10.3305/ nh.2012.27.3.5724

  2. Mercadal G, Lluch J, Campillo C, Torrent M. Association between nutritional risk based on the NRS-2002 test and hospital morbidity and mortality. Nutr Hosp. 2012 Jul;27(4):1248-54. DOI: http://dx.doi.org/10.3305/ nh.2012.27.4.5791.

  3. Salvador L, Fernández MS, Murillo J. Desnutrición y factores que influyen en la ingesta de alimentos en pacientes hospitalizados: una revisión. Nutr Clín Diet Hosp. 2014 Nov; 34(3): 80-91. DOI: http://dx.doi.org/10 .12873/343salvadormonferrer

  4. Pérez JE, Chávez M, Larios YE, García J, Rendón J, Salazar M, et al. Evaluación del estado nutricional al ingreso hospitalario y su asociación con la morbilidad y mortalidad en pacientes mexicanos. Nutr Hosp. 2016 Jul; 33(4): 872-78. DOI: http://dx.doi.org/10.20960/nh.386

  5. Frankenfield DC, Smith JS, Cooney RN, Blosser SA, Sarson GY. Relative association of fever and injury with hypermetabolism in critically ill patients. Injury. 1997 Nov-Dec; 28(9–10): 617–21. DOI: http://dx.doi. org/10.1016/S0020-1383(97)00117-4

  6. Maung AA, Davis KA. Nutritional support: inmunonutrition, probiotics, and anabolic steroids. Surg Clin N Am. 2012 Abr; 92 (2): 273–83. DOI: http://dx.doi. org/10.1016/j.suc.2012.01.014

  7. Kondrup J, Rasmussen HH, Hamberg O, Stanga Z. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003 Jun; 22(3): 321–36. DOI: http://dx.doi. org/10.1016/S0261-5614(02)00214-5

  8. Neelemaat F, Meijers J, Kruizenga H, Van Ballegooijen H, Van Bokhorst-de van der Schueren M. Comparison of five malnutrition screening tools in one hospital inpatient sample. J Clin Nurs. 2011 Ago; 20(15–16): 2144–52. DOI: http://dx.doi.org/10.1111/j.1365-2702.2010.03667

  9. Alvarez K, delgadillo T, García A, Alatriste G, fuchs V. Prevalencia de riesgo de desnutrición evaluada con NRS- 2002 en población oncológica mexicana. Nutr Hosp. 2014 Jul; 30(1): 173-78. DOI: http://dx.doi.org/10.3305/ nh.2014.30.1.7461.

  10. Jaimes E, Zuñiga MG, Medina A, Reyes DY, Cruz AB. Prevalencia de riesgo nutricional en un hospital de segundo nivel en el estado de México. Nutr Clín Diet Hosp. 2016 Oct; 36(4): 11-16. DOI: 10.12873/364jaimes

  11. Waitzberg DL, Ravacci GR, Raslan M. Desnutrición hospitalaria. Nutr Hosp. 2011 Mar; 26 (2): 254-64. DOI: http://dx.doi.org/10.3305/nh.2011.26.2.5070

  12. Kehlet H. Surgical stress response: does endoscopic surgery confer an advantage? World J Surg. 1999 Ago; 23(8): 801–7. DOI: http://dx.doi.org/10.1007/ s002689900583

  13. Desborough JP. The stress reponse to trauma and surgery. BJA. 2000 Jul; 85(1): 109-17. DOI: http:// dx.doi.org/10.1093/bja/85.1.109

  14. Blackburn GL. Metabolic considerations in management of surgical patients. Surg Clin N Am. 2011 Jun; 91(3): 467– 80. DOI: http://dx.doi.org/10.1016/j.suc.2011.03.001.

  15. Cerra FB, Siegel JH, Coleman B, Border JR, McMenamy RR. Septic autocannibalism. A failure of exogenous nutritional support. Ann Surg. 1980 Oct; 192(4): 570–80. DOI: http://dx.doi.org/10.1097/00000658-198010000- 00015.




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