Eunjung Kim1, Jae Seung Kang2, Youngmin Han2, Hongbeom Kim2, Wooil Kwon2, Jae Ri Kim2, Sun-Whe Kim2, Jin-Young Jang3. 1. Departments of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea; Department of Nursing, Graduate School, Kyung Hee University, Seoul, South Korea. 2. Departments of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. 3. Departments of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea. Electronic address: jangjy4@snu.ac.kr.
Abstract
BACKGROUND: This study investigated the clinical outcomes according to the preoperative nutritional status and to identify factors influencing long-term unrecovered nutritional status. METHODS: Data were prospectively collected from 355 patients who underwent PD between 2008 and 2014. Nutritional status was evaluated by Mini Nutrition Assessment (MNA) and patients were classified into group A (malnourished), group B (risk-of-malnutrition), or group C (well-nourished). MNA score, complications, body mass index (BMI), stool elastase level, biochemical parameters, and quality-of-life (QOL) were collected serially for 1 year. RESULTS: Preoperatively, 60 patients were categorized into group A, 224 into group B, and 71 into group C. Overall complication and pancreatic fistula were higher in groups A and B compared with group C (P = 0.003 vs P = 0.004). QOL, biochemical parameters, BMI and stool elastase level were lowest in group A preoperatively. BMI and stool elastase level remained low after surgery in all groups. Advanced age, low BMI, pre-existing diabetes mellitus, jaundice, exocrine insufficiency and adjuvant therapy were factors influencing long-term unrecovered nutritional status. CONCLUSION: Preoperative malnourished patients suffer from poor clinical outcomes. Therefore, those with risk factors of malnutrition should be monitored and vigorous efforts are needed to improve their nutrition.
BACKGROUND: This study investigated the clinical outcomes according to the preoperative nutritional status and to identify factors influencing long-term unrecovered nutritional status. METHODS: Data were prospectively collected from 355 patients who underwent PD between 2008 and 2014. Nutritional status was evaluated by Mini Nutrition Assessment (MNA) and patients were classified into group A (malnourished), group B (risk-of-malnutrition), or group C (well-nourished). MNA score, complications, body mass index (BMI), stool elastase level, biochemical parameters, and quality-of-life (QOL) were collected serially for 1 year. RESULTS: Preoperatively, 60 patients were categorized into group A, 224 into group B, and 71 into group C. Overall complication and pancreatic fistula were higher in groups A and B compared with group C (P = 0.003 vs P = 0.004). QOL, biochemical parameters, BMI and stool elastase level were lowest in group A preoperatively. BMI and stool elastase level remained low after surgery in all groups. Advanced age, low BMI, pre-existing diabetes mellitus, jaundice, exocrine insufficiency and adjuvant therapy were factors influencing long-term unrecovered nutritional status. CONCLUSION: Preoperative malnourished patients suffer from poor clinical outcomes. Therefore, those with risk factors of malnutrition should be monitored and vigorous efforts are needed to improve their nutrition.
Authors: Shengnan Zhou; Zhangping Yu; Xiaodong Shi; Huaiyu Zhao; Menghua Dai; Wei Chen Journal: Int J Environ Res Public Health Date: 2022-05-25 Impact factor: 4.614
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