[Prognostic value of nutritional indices for digestive tract cancer surgery in the African environment].
Malnutrition occurs in all patients digestive tract cancer and its effects on perioperative mortality have been well documented. However no study has assessed the predictive value of nutritional status within the context of facilities available in Africa. The purpose of this study was to determine the prognostic value of nutritional status for perioperative mortality in patients with digestive tract cancer i Dakar, Senegal. All patients that underwent surgery for digestive tract cancer were included. Preoperative assessment included physical examination (weight, mid-upper arm circumference, triceps skinfold thickness, and theoretical and real weight loss) and laboratory tests (serum albumin and creatinine/height index). The only evaluation criteria that was correlated was mortality at 14 days. Of the 40 patients included, 18 died (45%). In these 40 patients, 240 malnutrition tests were performed revealing 101 criteria of malnutrition. The results of laboratory tests were not correlated with mortality of clinical factors nor with each other. Physical findings were well correlated with each other but only real weight loss was correlated with postoperative mortality which ranged from 10% when weight loss was less than 10% to 100% when weight loss was 40% or higher. These findings emphasize the value of simply assessing real weight loss, which is difficult in Africa, for predicting perioperative mortality in patients with digestive tract cancer. Use of other physical criteria and especially more elaborate laboratory tests was not of further clinical value.
Ndiaye
M
M
Service de Réanimation, l'Hôpital principal, Dakar, Sénégal.
Angel
G
G
Diatta
B
B
Guerre-Berthelot
P
P
Seignot
P
P
D004067:Digestive System Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D012675:Senegal; D012680:Sensitivity and Specificity