title: Preoperative nutritional assessment and prognosis in patients with foregut tumors.
abstract: Malnourished patients with gastrointestinal tumours are at risk for postoperative complications and death. The aim of this study was to determine which nutritional assessment method better predicts outcome. Seventy-four patients, 45 men and 29 women; mean (SD) age of 63 (102) yr (range = 34 to 83), undergoing surgical resections for esophageal (n = 19) gastric (n = 43) and pancreatic (n = 12) tumors were preoperatively assessed by Patient Generated Subjective Global Assessment, anthropometry, and by laboratory sampling. Forty-three (58%) of them were unnourished; 25 Subjective Global Assessment (SGA)-A, 34 SGA-B, and 15 SGA-C cases. Mean (SD) of dominant hand adductor pollicis muscle thickness (DAPM) was 13 (3.5) mm and mean (SD) serum albumin was 3.8 (0.5) g/dL. Mean (SD) hospital staying for patients who complicated and died was 34 (29) days and 23 (13) days for survivors (not significant); SGA-B cases were significantly associated with higher mortality (n = 12, P<0.001). Patients with a mean (SD) DAPM below 10.8 (3.7) mm died more frequently than those with a mean (SD) greater than 14 (3) mm (P < 0.001). None of the methods was significantly related to hospital stay, but receiver operating characteristic curves (95% confidence interval) for PG-SGA and DAPM thickness (0.75 and 0.74) reliably predicted mortality (P<0.001) and these methods may be used as preoperative parameter.
authors.affiliation: Postgraduate Programme of Surgery, Rio Grande do Sul Federal University, Porto Alegre, RS, Brazil. akirjner@yahoo.com.br
authors.forename: Aline Kirjner
authors.initials: AK
authors.lastname: Poziomyck
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Weston
authors.forename: Edson Braga
authors.initials: EB
authors.lastname: Lameu
authors.forename: Ornella Sari
authors.initials: OS
authors.lastname: Cassol
authors.forename: Luisa Jussara
authors.initials: LJ
authors.lastname: Coelho
authors.forename: Luis Fernando
authors.initials: LF
authors.lastname: Moreira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D004938:Esophageal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006225:Hand; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D008875:Middle Aged; D015596:Nutrition Assessment; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000032:analysis
chemical_list: D012709:Serum Albumin