Nutritional status and postoperative outcomes in patients with gastrointestinal cancer in Vietnam: a retrospective cohort study.

BACKGROUND: Nutritional support for surgical care is crucial because hospital malnutrition is rather common. However, low- and middle-income countries have not adequately addressed nutritional management of surgical patients. To highlight need for nutritional management in surgical patients, the present study aimed to describe preoperative nutritional status in patients who underwent gastrointestinal cancer surgery in Vietnam and to investigate the relationship between preoperative malnutrition and adverse outcomes, such as postoperative complications and prolonged length of hospital stay. METHODS: We reviewed medical records of patients who underwent a major curative surgery for gastrointestinal cancer at the national hospital in Ho Chi Minh City, Vietnam. We identified preoperative malnutrition based on body mass index and serum albumin level, and postoperative complications in the first 30 d postoperative. We estimated the relative influence of malnutrition on complications and length of hospital stay using multivariate regression models. RESULTS: Of 459 eligible patients, 63% had colorectal cancer, 33% gastric cancer, and 4% esophageal cancer. The prevalence of malnutrition was 19%. No patients died during hospitalization; however, 26% developed complications after surgery. The average length of hospital stay was 14 d. After controlling for potential confounders, preoperative malnutrition was associated with an increased risk of postoperative complications (odds ratio = 1.97) and prolonged hospital stay (2.8 d). CONCLUSIONS: Preoperative malnutrition affects surgical outcomes among patients with gastrointestinal cancer in Vietnam. We recommend implementing preoperative nutritional interventions to achieve better outcomes among surgical cancer patients.

An effectiveness trial of multiple micronutrient supplementation during pregnancy in Vietnam: impact on birthweight and on stunting in children at around 2 years of age.

BACKGROUND: Multiple micronutrient deficiencies during pregnancy in Vietnam may contribute to poor fetal growth and stunting, which are major determinants of the health and development offuture generations. OBJECTIVE: We assessed the effects of prenatal multiple micronutrient supplementation on maternal weight gain during pregnancy, infant birthweight, and height of the child at around 2 years of age. METHODS: We conducted a nonrandomized, non-blinded, side-by-side effectiveness trial in a normal program setting in three districts in the Red River Delta in the north of Vietnam. Women in one district received the standard iron-folic acid supplement during prenatal care; women in the second district received the multiple micronutrient supplement; in the third district, gender training was provided in addition to the multiple micronutrient supplement. Cluster surveys were carried out in the three districts at the end of the trial to verify low birthweight (LBW) and at around 2 years after the trial to measure children's height and weight, as well as to collect demographic data on the mothers. RESULTS: Mean birthweight was higher in the districts receiving multiple micronutrient supplements than in the district receiving iron-folic acid tablets. The mean birthweight was 166 g higher in the district receiving multiple micronutrients and 105 g higher in the district receiving multiple micronutrients with gender training than in the district receiving iron-folic acid (p < .05). The prevalence of LBW children (< 2500 g) was lower in the district receiving multiple micronutrients (4.0%) and the district receiving multiple micronutrients plus gender training (5.8%) than in the district receiving iron-folic acid (10.6%) (p < .05). Children at around 2 years of age were taller in the district receiving multiple micronutrients (82.66 cm) and the district receiving multiple micronutrients plus gender training (83.61 cm) than in the district receiving iron-folic acid (81.64 cm), and the stunting rates were about 10% lower than in the district receiving iron-folic acid. CONCLUSIONS: Multiple micronutrient supplementation during pregnancy could be an important intervention to help reduce stunting rates in Vietnam.