title: Nutritional status and postoperative outcome after pneumonectomy for lung cancer.
abstract: BACKGROUND
  The influence of nutritional status on outcome after major lung resection remains controversial. Nutritional assessment is not included as a major recommendation in lung cancer guidelines. The purpose of this study was to assess the nutritional status of patients referred for pneumonectomy and to assess the predictive value of malnutrition in determining the surgical outcome.
  
  
  METHODS
  This study was a multicenter observational trial. The eligibility criterion for participants was pneumonectomy for lung cancer. Criteria for group classification according to nutritional status were albumin and transthyretin levels. Predicted outcomes were major infectious and noninfectious complications and 90-day mortality. Univariate analysis identified independent variables for the predictive model of age, sex, induction chemotherapy, extended resections, treatment side, smoking, and malnutrition. Predictive variables were then included in a logistic regression model.
  
  
  RESULTS
  Between January 2010 and December 2011, 86 (mean age, 61.5 years) consecutive patients referred for pneumonectomy (left side, n = 58; right side, n = 28) at 4 thoracic surgery centers were included. The malnutrition group included 33 patients (39%) and the normal nutritional status group included 53 patients. Univariate analysis elected malnutrition, recent active smoking, and extended resection to be included in a multivariate analysis. Multivariate analysis identified malnutrition, recent smoking, and extended resection as predictive variables for major complications and mortality.
  
  
  CONCLUSIONS
  The frequency of malnutrition detected by biological markers was dramatically high. Malnutrition, as well as recent active smoking and extended resection, is a predictive factor for infectious complications and mortality after pneumonectomy. Nutritional assessment with appropriate markers should be considered before pneumonectomy.
authors: Georges Pompidou European Hospital, Rene Descartes University, Paris, France. patrick.bagan@ch-argenteuil.fr
authors: Patrick
authors: P
authors: Bagan
authors: Pascal
authors: P
authors: Berna
authors: Florence
authors: F
authors: De Dominicis
authors: Joao Carlos
authors: JC
authors: Das Neves Pereira
authors: Pierre
authors: P
authors: Mordant
authors: Bertrand
authors: B
authors: De La Tour
authors: Francoise
authors: F
authors: Le Pimpec-Barthes
authors: Marc
authors: M
authors: Riquet
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000453:epidemiology*; D008875:Middle Aged; D009752:Nutritional Status; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D016896:Treatment Outcome