Weight loss and BMI criteria in GLIM's definition of malnutrition is associated with postoperative complications following abdominal resections - Results from a National Quality Registry

被引:99
作者
Skeie, Eli [1 ,2 ]
Tangvik, Randi Julie [1 ,3 ]
Nymo, Linn Save [4 ]
Harthug, Stig [1 ,2 ]
Lassen, Kristoffer [5 ,6 ]
Viste, Asgaut [1 ,3 ]
机构
[1] Haukeland Hosp, Dept Res & Dev, Postboks 1400, Bergen 5021, Norway
[2] Univ Bergen, Dept Clin Med, Bergen, Norway
[3] Univ Bergen, Dept Clin Sci, Bergen, Norway
[4] Univ Hosp North Norway, Dept Gastrointestinal Surg, Tromso, Norway
[5] Oslo Univ Hosp, Dept Gastroenterol Surg, Rikshosp, HPB Sect, Oslo, Norway
[6] Arctic Univ Tromso, Inst Clin Med, Tromso, Norway
关键词
Nutritional status; Preoperative malnutrition; Postoperative complications; BODY-MASS-INDEX; OLDER-ADULTS; MORTALITY; OUTCOMES; CANCER; IMPACT; MORBIDITY; OBESITY; COHORT; HEALTH;
D O I
10.1016/j.clnu.2019.07.003
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aims: Although malnutrition is thought to be common among patients with intraabdominal diseases and is recognized as a risk factor for postoperative complications, diagnostic criteria for malnutrition have not been consistent. Thus, the Global Leadership Initiative in Malnutrition (GLIM) has recently published new criteria for malnutrition. The aims of this study were to investigate the prevalence of malnutrition according to weight loss and BMI criteria in GLIM's second step for the diagnosis and their association with severe postoperative complications in patients undergoing gastrointestinal resections. Method: The current study includes adult patients who were prospectively included in the Norwegian Registry for Gastrointestinal Surgery in the period between 2015 and 2018. Exclusion criteria were acute surgery and lack of information regarding preoperative weight and/or postoperative complications. Severe surgical complications were classified according to the Revised Accordion Classification system and malnutrition with the GLIM criteria. Associations were assessed by logistic regression analyses, and the adjusted odds ratio included age (continuous), gender (male/female) and scores from the American Society of Anesthesiologists Physical Status Classification System and the Eastern Cooperative Oncology Group. Results: Out of 6110 patients, 2161 (35.4%) were classified as with malnutrition, 1206 (19.7%) with moderate and 955 (15.6%) with severe malnutrition. Malnourished patients were 1.29 (95% CI: 1.13-1.47) times more likely to develop severe surgical complications, and 2.15 (95% CI: 1.27-3.65) times more likely to die within 30 days, as compared to those who were not. Conclusion: Preoperative malnutrition is common among patients having gastrointestinal resections and is associated with an increased risk of severe surgical complications. (C) 2019 The Authors. Published by Elsevier Ltd.
引用
收藏
页码:1593 / 1599
页数:7
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