Cargando…
Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study
BACKGROUND/AIMS: We investigated the effect of preoperative malnutrition on postoperative surgical outcomes in elderly patients undergoing pancreatoduodenectomy for periampullary neoplasms. METHODS: This prospective cohort study enrolled 154 patients aged ≥65 years with periampullary neoplasms. Usin...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Editorial Office of Gut and Liver
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860041/ https://www.ncbi.nlm.nih.gov/pubmed/30970428 http://dx.doi.org/10.5009/gnl18469 |
_version_ | 1783471220975468544 |
---|---|
author | Kim, Eunjung Lee, Doo-Ho Jang, Jin-Young |
author_facet | Kim, Eunjung Lee, Doo-Ho Jang, Jin-Young |
author_sort | Kim, Eunjung |
collection | PubMed |
description | BACKGROUND/AIMS: We investigated the effect of preoperative malnutrition on postoperative surgical outcomes in elderly patients undergoing pancreatoduodenectomy for periampullary neoplasms. METHODS: This prospective cohort study enrolled 154 patients aged ≥65 years with periampullary neoplasms. Using the Mini Nutritional Assessment tool, patients were categorized into three groups according to their preoperative nutritional status: well-nourished (13.0%), at-risk-of-malnutrition (59.7%), and malnourished (27.3%). RESULTS: Significant intergroup differences were observed in preoperative body mass index (25.6±2.4 kg/m(2) [well-nourished] vs 23.4±2.6 kg/m(2) [at-risk-of-malnutrition] vs 21.1±2.8 kg/m(2) [malnourished], p<0.001). The overall morbidity significantly differed between the well-nourished and malnourished groups (20% vs 50.0%, p=0.024). The rates of clinically significant postoperative pancreatic fistula were significantly different among groups (p=0.035). Univariate and multivariate analyses showed that the at-risk-of-malnutrition or malnourished status (hazard ratio [HR], 3.45; p=0.037) and intraoperative blood loss (HR, 1.01; p=0.040) significantly affected the overall postoperative morbidity in elderly patients. CONCLUSIONS: Before surgery, 87.0% of patients were classified into the at-risk-of-malnutrition or malnourished group. Compared with well-nourished patients, patients with nutritional issues showed a higher overall surgical morbidity. Improved preoperative nutritional status leads to favorable surgical outcomes in elderly patients. |
format | Online Article Text |
id | pubmed-6860041 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Editorial Office of Gut and Liver |
record_format | MEDLINE/PubMed |
spelling | pubmed-68600412019-11-27 Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study Kim, Eunjung Lee, Doo-Ho Jang, Jin-Young Gut Liver Original Article BACKGROUND/AIMS: We investigated the effect of preoperative malnutrition on postoperative surgical outcomes in elderly patients undergoing pancreatoduodenectomy for periampullary neoplasms. METHODS: This prospective cohort study enrolled 154 patients aged ≥65 years with periampullary neoplasms. Using the Mini Nutritional Assessment tool, patients were categorized into three groups according to their preoperative nutritional status: well-nourished (13.0%), at-risk-of-malnutrition (59.7%), and malnourished (27.3%). RESULTS: Significant intergroup differences were observed in preoperative body mass index (25.6±2.4 kg/m(2) [well-nourished] vs 23.4±2.6 kg/m(2) [at-risk-of-malnutrition] vs 21.1±2.8 kg/m(2) [malnourished], p<0.001). The overall morbidity significantly differed between the well-nourished and malnourished groups (20% vs 50.0%, p=0.024). The rates of clinically significant postoperative pancreatic fistula were significantly different among groups (p=0.035). Univariate and multivariate analyses showed that the at-risk-of-malnutrition or malnourished status (hazard ratio [HR], 3.45; p=0.037) and intraoperative blood loss (HR, 1.01; p=0.040) significantly affected the overall postoperative morbidity in elderly patients. CONCLUSIONS: Before surgery, 87.0% of patients were classified into the at-risk-of-malnutrition or malnourished group. Compared with well-nourished patients, patients with nutritional issues showed a higher overall surgical morbidity. Improved preoperative nutritional status leads to favorable surgical outcomes in elderly patients. Editorial Office of Gut and Liver 2019-11 2019-05-27 /pmc/articles/PMC6860041/ /pubmed/30970428 http://dx.doi.org/10.5009/gnl18469 Text en Copyright © 2019 by The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Eunjung Lee, Doo-Ho Jang, Jin-Young Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study |
title | Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study |
title_full | Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study |
title_fullStr | Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study |
title_full_unstemmed | Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study |
title_short | Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study |
title_sort | effects of preoperative malnutrition on postoperative surgical outcomes and quality of life of elderly patients with periampullary neoplasms: a single-center prospective cohort study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6860041/ https://www.ncbi.nlm.nih.gov/pubmed/30970428 http://dx.doi.org/10.5009/gnl18469 |
work_keys_str_mv | AT kimeunjung effectsofpreoperativemalnutritiononpostoperativesurgicaloutcomesandqualityoflifeofelderlypatientswithperiampullaryneoplasmsasinglecenterprospectivecohortstudy AT leedooho effectsofpreoperativemalnutritiononpostoperativesurgicaloutcomesandqualityoflifeofelderlypatientswithperiampullaryneoplasmsasinglecenterprospectivecohortstudy AT jangjinyoung effectsofpreoperativemalnutritiononpostoperativesurgicaloutcomesandqualityoflifeofelderlypatientswithperiampullaryneoplasmsasinglecenterprospectivecohortstudy |