2001, Number 4
The predictive value of albumin in the surgical patient with digestive tract cancer
Tapia JJ, Trueba PPA, Fajardo RA
Language: Spanish
References: 10
Page: 290-295
PDF size: 41.81 Kb.
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