Are patients at nutritional risk more prone to complications after major urological surgery?

Details

Serval ID
serval:BIB_BE1935BCC10C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Are patients at nutritional risk more prone to complications after major urological surgery?
Journal
Journal of Urology
Author(s)
Cerantola Y., Valerio M., Hubner M., Iglesias K., Vaucher L., Jichlinski P.
ISSN
1527-3792 (Electronic)
ISSN-L
0022-5347
Publication state
Published
Issued date
2013
Volume
190
Number
6
Pages
2126-2132
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
PURPOSE: The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional risk score of 3 or greater predicts adverse outcomes after digestive surgery, to our knowledge its predictive value for morbidity after urological interventions is unknown. We determined whether urological patients at nutritional risk are at higher risk for complications after major surgery than patients not at nutritional risk.
MATERIALS AND METHODS: We performed a prospective observational study in consecutive patients undergoing major surgery. A priori sample calculation resulted in a study cohort of 220 patients. Interim analysis was planned after 110 patients. The nutritional risk score was assessed preoperatively by a specialized study nurse. Nutritional care was standardized in all patients. Postoperative complications were defined previously using the standardized Dindo-Clavien classification. The primary end point was 30-day morbidity. Univariate and multivariate analysis was performed to identify predictors of complications.
RESULTS: The study was discontinued due to significant results after interim analysis. A total of 125 patients were included in analysis from June 2011 to June 2012 and 15 were excluded because of incomplete data. Of 51 patients at nutritional risk 38 (74%) presented with at least 1 complication compared to 28 of 59 controls (47%). Patients at nutritional risk were at threefold risk for complications on univariate and multivariate analysis (OR 3.3, 95% CI 1.3-8.0). Cystectomy was the only other predictor of morbidity (OR 10, 95% CI 2-48).
CONCLUSIONS: Patients at nutritional risk are more prone to complications after major urological procedures. Whether this increased morbidity can be reversed by perioperative nutritional support should be studied.
Pubmed
Web of science
Create date
22/12/2013 17:45
Last modification date
20/08/2019 16:32
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