title: [Nutritional support and risk factors of appearance of enterocutaneous fistulas].
abstract: BACKGROUND
  Among the different factors described, nutritional support has been associated to prevention and management of enterocutaneous fistulae (ECF).
  
  
  OBJECTIVE
  To assess the influence that the parameters related to nutritional, clinical status, and surgical variables have on the occurrence of ECF.
  
  
  METHODS
  An observational case/control retrospective study was performed on patients admitted to the General and Digestive Surgery Department. The parameters analyzed were: diagnosis, body mass index (BMI), pathologic personal history, number of surgical interventions (SI) and complications (previous infection, bleeding, and ischemia). In patients with SI, we analyzed: number and type of SI, time until onset of nutritional support, and type of nutritional support. We performed a multiple logistic uni- and multivariate regression analysis by using the SPSSv.19.0 software.
  
  
  RESULTS
  The primary diagnoses related to the occurrence of ECF were pancreatic pathology (OR = 5.346) and inflammatory bowel disease (IBD) (OR = 9.329). The surgical variables associated to higher prevalence of ECF emergency SI (OR = 5.79) and multiple SI (OR = 4.52). Regarding the nutritional variables, the late onset of nutrition (more than three days after SI) was associated to the occurrence of ECF (OR = 3.82).
  
  
  CONCLUSIONS
  In surgical patients, early nutritional support , independently of the route of administration, decreases the occurrence of fistulae. Pancreatic pathology, IBD, emergency SI, and multiple SI were associated to higher prevalence of ECF. The variable hyponutrition appears as a risk factor that should be confirmed in further studies.
authors.affiliation: Servicio de Farmacia, Hospital Universitari de Bellvitge, Instituto de Investigacion Biomedica de Bellvitge, Barcelona, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Llop
authors.forename: S
authors.initials: S
authors.lastname: Cobo
authors.forename: A
authors.initials: A
authors.lastname: Padullés
authors.forename: L
authors.initials: L
authors.lastname: Farran
authors.forename: R
authors.initials: R
authors.lastname: Jódar
authors.forename: M B
authors.initials: MB
authors.lastname: Badia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D017577:Cutaneous Fistula / Q000517:prevention & control* / Q000601:surgery; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications; D007412:Intestinal Fistula / Q000517:prevention & control* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support; D010182:Pancreatic Diseases / Q000150:complications; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D012307:Risk Factors; D055815:Young Adult