Preoperative nutrition forseverely malnourished patients in digestive surgery: A retrospective study.
J Visc Surg
; 157(2): 107-116, 2020 Apr.
Article
en En
| MEDLINE
| ID: mdl-31366442
ABSTRACT
INTRODUCTION:
Malnutrition increases postoperative morbidity and mortality. The objective of this study was to evaluate preoperative refeeding in malnourished patients at risk of refeeding syndrome (RS).METHODOLOGY:
A retrospective study, conducted between June 2016 and January 2017, reported to the CNIL, compared two groups of malnourished patients a group of refeeding patients (RP) and a group of non-refeeding patients (NRP). The inclusion criteria were weight loss of more than 10% or albuminemia less than 35g/L and RS risk factor. The primary endpoint was postoperative morbidity. The secondary endpoints were weight change and serum albumin over 6 months.RESULTS:
Seventy-three patients (30 RP and 43 NRP) were included. At the time of initial management, median weight loss was 18% [1-71], while albuminemia was 26g/L [13-40] in the RP group and 32.5g/L [32-48] in the NRP group (P=0.01). The overall postoperative morbidity rate was 88% (83% RP versus 90% NRP, P=0.47), and there was no significant difference between the 2 groups. The rate of anastomotic complications was 4% for RP versus 26% for NRP (P=0.03) after exclusion of liver surgery. Medium-term weight loss tended to be greater in RP (P=0.7). Nutritional support was continued until the third postoperative month in 13% of RPs vs. no NRPs (P=0.0002).CONCLUSION:
After preoperative renutrition, we did not observe a decrease in morbidity but rather a decrease in the rate of anastomotic complications in favor of the RP group. This study underscores the middle-term importance of nutritional management in view of preserving the benefits of preoperative renutrition.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
6_malnutrition_nutritional_deficiencies
Asunto principal:
Complicaciones Posoperatorias
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Procedimientos Quirúrgicos del Sistema Digestivo
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Cuidados Preoperatorios
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Apoyo Nutricional
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Desnutrición
Tipo de estudio:
Etiology_studies
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Evaluation_studies
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Observational_studies
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Adult
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Aged
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Aged80
/
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Visc Surg
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2020
Tipo del documento:
Article