Prevalence and Consequences of Preoperative Weight Loss in Gynecologic Surgery.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_C6E5C0BF95C6
Type
Article: article from journal or magazin.
Collection
Publications
Title
Prevalence and Consequences of Preoperative Weight Loss in Gynecologic Surgery.
Journal
Nutrients
Author(s)
Pache B., Grass F., Hübner M., Kefleyesus A., Mathevet P., Achtari C.
ISSN
2072-6643 (Electronic)
ISSN-L
2072-6643
Publication state
Published
Issued date
17/05/2019
Peer-reviewed
Oui
Volume
11
Number
5
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Preoperative malnutrition and weight loss negatively impact postoperative outcomes in various surgical fields. However, for gynecologic surgery, evidence is still scarce, especially if surgery is performed within enhanced recovery after surgery (ERAS) pathways. This study aimed to assess the prevalence and impact of preoperative weight loss in patients undergoing major gynecologic procedures within a standardized ERAS pathway between October 2013 and January 2017. Out of 339 consecutive patients, 33 (10%) presented significant unintentional preoperative weight loss of more than 5% during the 6 months preceding surgery. These patients were less compliant to the ERAS protocol (>70% of all items: 70% vs. 94%, p < 0.001) presented more postoperative overall complications (15/33 (45%) vs. 69/306 (22.5%), p = 0.009), and had an increased length of hospital stay (5 ± 4 days vs. 3 ± 2 days, p = 0.011). While patients experiencing weight loss underwent more extensive surgical procedures, after multivariate analysis, weight loss ≥5% was retained as an independent risk factor for postoperative complications (OR 2.44; 95% CI 1.00-5.95), and after considering several surrogates for extensive surgery including significant blood loss (OR 2.23; 95% CI 1.15-4.31) as confounders. The results of this study suggest that systematic nutritional screening in ERAS pathways should be implemented.
Keywords
Adult, Aged, Aged, 80 and over, Female, Humans, Length of Stay, Middle Aged, Multivariate Analysis, Perioperative Care, Postoperative Complications, Recovery of Function, Retrospective Studies, Weight Loss, enhanced recovery, gynecologic/oncology, gynecology, nutrition, prehabilitation, surgery, weight loss
Pubmed
Web of science
Open Access
Yes
Create date
25/05/2019 11:46
Last modification date
11/01/2020 7:16
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