This journal only 2001, Number 4 Cir Gen 2001; 23 (4) The predictive value of albumin in the surgical patient with digestive tract cancer Tapia JJ, Trueba PPA, Fajardo RA Full text How to cite this article Language: Spanish References: 10 Page: 290-295 PDF size: 41.81 Kb. Key words: Risk factor, nutritional index, cancer, digestive tract, albumin, morbidity, mortality. ABSTRACT Introduction: There are no objective, simple, accessible, and cheap nutritional evaluation parameters that might help to orient on the risk for morbidity and mortality in cancer of the digestive tract. Objective: To determine whether the nutritional assessment parameters, cutaneous triciptal fold (CTF), albumin (AL), total lymphocyte count (TLC), and muscle strength (MS), are useful as prognostic indicators of post-operative morbidity and mortality in cancer of the digestive tract. Setting: Third level health care hospital. Design: Cohort, prospective, longitudinal, observational, clinical study. Patients and methods: We studied 100 patients, aged between 18 and 90 years with confirmed cancer of the digestive tract, excluding those with AIDS, renal or hepatic failure, obese. During the pre-operative period the four (CTF, AL, TLC, MS) indicators were measured, their normal reference values for the geographic area were obtained from previous studies. Patients were followed for 30 days after surgery to record any complication (septic or non-septic) and mortality. Statistical analysis: Contingency tables for predictive value of the variables, logistic regression test for albumin, calculating RR, CI at 95, and p. Besides, we calculated t to assess the medians of the different parameters. Results: Distribution of the 100 cases according to the anatomical site of the cancer was: rectum, 32; stomach, 24; colon, 19; pancreas, 8; liver 5; others, 12. Morbidity was of 47% and mortality of 13%. Values of the medians of the four studied parameters were lower in those patients that died, they were also lower, except for CTF, in patients with complications. CTF, TLC, and MS yielded no statistical significant values to predict morbidity or mortality. AL was statistically significant to predict morbidity (p= 0.028) and mortality (p = 0.004). Conclusion: AL remains a useful parameter to indicate nutritional risk for morbidity and mortality in cancer of the digestive tract, followed by MS. REFERENCES Daly JM, Shinkwin M. La nutrición en el paciente con cáncer. En: Murphy G, Lawrence W; Oncología clínica. Manual de la American Cancer Society. 2ª ed. EUA; Organización Panamericana de la Salud, American Cancer Society. 1996 650-69. Mullen JL, Gertner MH, Buzby GP, Goodhart GL, Rosato EF. Implications of malnutrition in the surgical patient. Arch Surg 1979;114:121-5. Davies MG, Hagen PO. Systemic inflammatory response syndrome. Br J Surg 1997;84:920-35. Studley HO. A basic indicator of surgical risk in patients with chronic peptic ulcer. JAMA 1936;106:548-60. Buzby GP, Knox LS, Crosby LO, Eisenberg JM, Haakenson CM, McNeal GE. Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients. Am J Clin Nutr 1988;47(2 Suppl):366-81. Pearlstone DB, Lee JI, Alexander RH, Chang TH, Brennan MF, Burt M. Effect of enteral and parenteral nutrition on amino acid levels in cancer patients. JPEN J Parenter Enteral Nutr 1995;19:204-8. Butters M, Straub M, Kraft K, Bittner R. Studies on nutritional status in general surgery patients by clinical, anthropometric and laboratory parameters. Nutrition 1996;2:405-10. Rey-Ferro M, Castano R, Orozco O, Serna A, Moreno A. Nutritional and immunologic evaluation of patients with gastric cancer before and after surgery. Nutrition 1997;13:878-81. Cuachayo J, Tapia J, Hernández F, Revilla MC, Novello B, Quintana E. Parámetros de evaluación nutricia en donadores de sangre del Centro Médico Nacional, Trabajo libre, presentado en el VIII Congreso de la Asociación Mexicana de Alimentación Enteral y Endovenosa, 1997, Acapulco, Gro. México. Ramírez V. Valores de referencia de parámetros de evaluación nutricia en una población de adulto mayor. [Tesis] México: Universidad Iberoamericana; 2000.