Prevalence and Consequences of Preoperative Weight Loss in Gynecologic Surgery.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_C6E5C0BF95C6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prevalence and Consequences of Preoperative Weight Loss in Gynecologic Surgery.
Périodique
Nutrients
Auteur(s)
Pache B., Grass F., Hübner M., Kefleyesus A., Mathevet P., Achtari C.
ISSN
2072-6643 (Electronic)
ISSN-L
2072-6643
Statut éditorial
Publié
Date de publication
17/05/2019
Peer-reviewed
Oui
Volume
11
Numéro
5
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
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.
Mots-clé
enhanced recovery, gynecologic/oncology, gynecology, nutrition, prehabilitation, surgery, weight loss
Pubmed
Web of science
Open Access
Oui
Création de la notice
25/05/2019 10:46
Dernière modification de la notice
20/08/2019 15:42
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