Influence of preoperative nutritional state on inflammatory response after surgery.
To investigate whether the preoperative nutritional state influences the postoperative inflammatory reaction and immunity, we grouped patients whose postoperative nutritional support was performed by total parenteral nutrition into the good nutritional state group (group I) and the latent protein-calorie malnutrition suggested group (group II) based on the preoperative rapid turnover protein (RTP). Nutritional markers markedly decreased after surgery and recovered almost to preoperative levels on postoperative day (POD-) 7 in groups I and II. Nutritional markers on POD-7 in group II were significantly lower than those in group I (RTP, P < 0.001; albumin, P < 0.05). After surgery, levels of interleukin-6 (IL-6), C-reactive protein (CRP), and polymorphonuclear (PMN-) elastase were higher in group II than in group I (P < 0.01). In groups I and II, IL-6 and interleukin-8 (IL-8) rose before the remarkable elevation of CRP and PMN-elastase. In group I, all the nutritional markers showed a negative correlation with CRP and PMN-elastase. Further, a positive correlation was observed between IL-6 and CRP and between IL-8 and PMN-elastase. In conclusion, evaluation of the preoperative nutritional state appears to be very important for the prediction of postoperative complication.
Nakamura
K
K
Department of Hospital Pharmacy, Kagoshima University Faculty of Medicine, Japan. nakamura@khosp3.kufm.kagoshima-u.ac.jp
Moriyama
Y
Y
Kariyazono
H
H
Hamada
N
N
Toyohira
H
H
Taira
A
A
Yamada
K
K
D000368:Aged; D001798:Blood Proteins / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007109:Immunity; D007249:Inflammation / Q000150:complications*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D019272:Leukocyte Elastase / Q000097:blood; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications; D011228:Prealbumin / Q000032:analysis; D011300:Preoperative Care; D011502:Protein-Energy Malnutrition / Q000150:complications; D012177:Retinol-Binding Proteins / Q000032:analysis; D012709:Serum Albumin / Q000032:analysis; D014168:Transferrin / Q000032:analysis
D001798:Blood Proteins; D015850:Interleukin-6; D016209:Interleukin-8; D011228:Prealbumin; D012177:Retinol-Binding Proteins; D012709:Serum Albumin; D014168:Transferrin; D002097:C-Reactive Protein; D019272:Leukocyte Elastase