title: Malnutrition and pancreatic surgery: prevalence and outcomes.
abstract: BACKGROUND
  Pancreatic surgery is associated with severe postoperative morbidity. Identification of patients at high risk may provide a way to allocate resources objectively and focus care on those patients in greater need. The Authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients undergoing pancreatic surgery for malignant tumors.
  
  
  METHODS
  Data were collected from 143 patients who had undergone pancreatic resection for cancer. Prevalence of malnutrition was evaluated by several validated screening tools and correlated to the incidence of surgical site infection, overall morbidity, mortality, and hospital stay.
  
  
  RESULTS
  Overall, 88% of patients were at medium-high risk of malnutrition. Patients at high risk of malnutrition presented a fourfold longer postoperative hospitalization period and a higher morbidity rate (53.2%) than those patients at low risk of malnutrition. Malnutrition, evaluated by MUST and NRI, was an independent predictor of overall morbidity using multivariate analysis (P = 0.00145, HR = 2.6581, 95% CI = 1.3589-8.5698, and P = 0.07129, HR = 1.9953, 95% CI = 0.9723-13.548, respectively).
  
  
  CONCLUSIONS
  Malnutrition is a relevant predictor of post-operative morbidity and mortality after pancreatic surgery. Patients underwent pancreatic resection for malignant tumors are usually malnourished. Preoperative malnutrition screening is mandatory in order to assess the risk and to treat the malnutrition.
authors.affiliation: Department of General Surgery, University of Rome La Sapienza, St. Andrea Hospital, Via di Grottarossa, Rome, Italy. marco.latorre@uniroma1.it
authors.forename: Marco
authors.initials: M
authors.lastname: La Torre
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nigri
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallini
authors.forename: Genoveffa
authors.initials: G
authors.lastname: Balducci
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ramacciato
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D013156:Splenectomy; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D015431:Weight Loss
chemical_list: D012709:Serum Albumin; D002097:C-Reactive Protein