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Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease

In Crohn disease, bowel-preserving surgery is necessary to prevent short bowel syndrome due to repeated operations. This study aimed to determine the remnant small bowel length cut-off and to evaluate the clinical factors related to nutritional status after small bowel resection in Crohn disease. We...

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Autores principales: Jang, Ki Ung, Yu, Chang Sik, Lim, Seok-Byung, Park, In Ja, Yoon, Yong Sik, Kim, Chan Wook, Lee, Jong Lyul, Yang, Suk-Kyun, Ye, Byong Duk, Kim, Jin Cheon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2016
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265839/
https://www.ncbi.nlm.nih.gov/pubmed/27472702
http://dx.doi.org/10.1097/MD.0000000000004285
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author Jang, Ki Ung
Yu, Chang Sik
Lim, Seok-Byung
Park, In Ja
Yoon, Yong Sik
Kim, Chan Wook
Lee, Jong Lyul
Yang, Suk-Kyun
Ye, Byong Duk
Kim, Jin Cheon
author_facet Jang, Ki Ung
Yu, Chang Sik
Lim, Seok-Byung
Park, In Ja
Yoon, Yong Sik
Kim, Chan Wook
Lee, Jong Lyul
Yang, Suk-Kyun
Ye, Byong Duk
Kim, Jin Cheon
author_sort Jang, Ki Ung
collection PubMed
description In Crohn disease, bowel-preserving surgery is necessary to prevent short bowel syndrome due to repeated operations. This study aimed to determine the remnant small bowel length cut-off and to evaluate the clinical factors related to nutritional status after small bowel resection in Crohn disease. We included 394 patients (69.3% male) who underwent small bowel resection for Crohn disease between 1991 and 2012. Patients who were classified as underweight (body mass index < 17.5) or at high risk of nutrition-related problems (modified nutritional risk index < 83.5) were regarded as having a poor nutritional status. Preliminary remnant small bowel length cut-offs were determined using receiver operating characteristic curves. Variables associated with poor nutritional status were assessed retrospectively using Student t tests, chi-squared tests, Fisher exact tests, and logistic regression analyses. The mean follow-up period was 52.9 months and the mean patient ages at the time of the last bowel surgery and last follow-up were 31.2 and 35.7 years, respectively. The mean remnant small bowel length was 331.8 cm. Forty-three patients (10.9%) underwent ileostomy, 309 (78.4%) underwent combined small bowel and colon resection, 111 (28.2%) had currently active disease, and 105 (26.6%) underwent at least 2 operations for recurrent disease. The mean body mass index and modified nutritional risk index were 20.6 and 100.8, respectively. The independent factors affecting underweight status were remnant small bowel length ≤240 cm (odds ratio: 4.84, P < 0.001), ileostomy (odds ratio: 4.70, P < 0.001), and currently active disease (odds ratio: 4.16, P < 0.001). The independent factors affecting high nutritional risk were remnant small bowel length ≤230 cm (odds ratio: 2.84, P = 0.012), presence of ileostomy (odds ratio: 3.36, P = 0.025), and currently active disease (odds ratio: 4.90, P < 0.001). Currently active disease, ileostomy, and remnant small bowel length ≤230 cm are risk factors affecting the poor nutritional status of patients with Crohn disease after small bowel resection.
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spelling pubmed-52658392017-02-03 Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease Jang, Ki Ung Yu, Chang Sik Lim, Seok-Byung Park, In Ja Yoon, Yong Sik Kim, Chan Wook Lee, Jong Lyul Yang, Suk-Kyun Ye, Byong Duk Kim, Jin Cheon Medicine (Baltimore) 7100 In Crohn disease, bowel-preserving surgery is necessary to prevent short bowel syndrome due to repeated operations. This study aimed to determine the remnant small bowel length cut-off and to evaluate the clinical factors related to nutritional status after small bowel resection in Crohn disease. We included 394 patients (69.3% male) who underwent small bowel resection for Crohn disease between 1991 and 2012. Patients who were classified as underweight (body mass index < 17.5) or at high risk of nutrition-related problems (modified nutritional risk index < 83.5) were regarded as having a poor nutritional status. Preliminary remnant small bowel length cut-offs were determined using receiver operating characteristic curves. Variables associated with poor nutritional status were assessed retrospectively using Student t tests, chi-squared tests, Fisher exact tests, and logistic regression analyses. The mean follow-up period was 52.9 months and the mean patient ages at the time of the last bowel surgery and last follow-up were 31.2 and 35.7 years, respectively. The mean remnant small bowel length was 331.8 cm. Forty-three patients (10.9%) underwent ileostomy, 309 (78.4%) underwent combined small bowel and colon resection, 111 (28.2%) had currently active disease, and 105 (26.6%) underwent at least 2 operations for recurrent disease. The mean body mass index and modified nutritional risk index were 20.6 and 100.8, respectively. The independent factors affecting underweight status were remnant small bowel length ≤240 cm (odds ratio: 4.84, P < 0.001), ileostomy (odds ratio: 4.70, P < 0.001), and currently active disease (odds ratio: 4.16, P < 0.001). The independent factors affecting high nutritional risk were remnant small bowel length ≤230 cm (odds ratio: 2.84, P = 0.012), presence of ileostomy (odds ratio: 3.36, P = 0.025), and currently active disease (odds ratio: 4.90, P < 0.001). Currently active disease, ileostomy, and remnant small bowel length ≤230 cm are risk factors affecting the poor nutritional status of patients with Crohn disease after small bowel resection. Wolters Kluwer Health 2016-07-29 /pmc/articles/PMC5265839/ /pubmed/27472702 http://dx.doi.org/10.1097/MD.0000000000004285 Text en Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0
spellingShingle 7100
Jang, Ki Ung
Yu, Chang Sik
Lim, Seok-Byung
Park, In Ja
Yoon, Yong Sik
Kim, Chan Wook
Lee, Jong Lyul
Yang, Suk-Kyun
Ye, Byong Duk
Kim, Jin Cheon
Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease
title Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease
title_full Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease
title_fullStr Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease
title_full_unstemmed Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease
title_short Factors affecting poor nutritional status after small bowel resection in patients with Crohn disease
title_sort factors affecting poor nutritional status after small bowel resection in patients with crohn disease
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5265839/
https://www.ncbi.nlm.nih.gov/pubmed/27472702
http://dx.doi.org/10.1097/MD.0000000000004285
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