[Effects of malnutrition on infective morbidity in the surgical treatment of portal hypertension (prospective evaluation)].
With the aim of investigating the preoperative frequency of undernutrition and its impact on the infectious morbidity in patients without malignant disease, we studied prospectively 41 patients operated because of portal hypertension between 1987 and 1989 at the Instituto Nacional de la Nutrición. All patients were evaluated through anthropometric analysis and biochemical markers one week before the surgical procedure. A standard scheme of antibiotic profilaxis was used during surgery and the preoperative complications were registered up to discharge from the hospital. Undernutrition was considered when the serum albumin was less than 3 mg/dL or the total lymphocyte count was under 900, associated with a 10% weight loss in six months and reduction of one or more anthropometric parameters below the 30th percentile of the normal value. The group consisted of 17 males and 24 females with a mean age of 48 +/- 14 years old. 35 were Child A, four Child B and two Child C. Ten patients had a distal splenorenal shunt, seven esophageal devascularization and 24 gastric desvascularization with splenectomy. Twenty eight patients were well nourished and 13 undernourished. The two groups were comparable in all parameters except for the nutritional status. In the first group seven patients developed 10 complications and in the undernourished group eight patients had 14 complications (p less than 0.05 chi 2). There was no significant difference in the mortality rate. Infections occurred more frequently in: urinary tract, surgical wound, lung and pleura, and esophageal fistulae was an additional complication. The univariate analysis of the anthropometric parameters did not show significant differences between both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Herrera
M F
MF
Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, Tlalpan, México, D.F.
Hoyos
C
C
Prado
E
E
Orozco
H
H
D000328:Adult; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000601:surgery*; D007239:Infections / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009748:Nutrition Disorders / Q000150:complications*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011300:Preoperative Care; D011446:Prospective Studies
Efecto de la desnutrición sobre la morbilidad infecciosa en el tratamiento quirúrgico de la hipertensión portal (evaluación prospectiva).