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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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2016
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Materias: | |
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. |
format | Online Article Text |
id | pubmed-5265839 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
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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