title: Perioperative nutritional status changes in gastrointestinal cancer patients.
abstract: OBJECTIVE
  The presence of gastrointestinal (GI) cancer and its treatment might aggravate patient nutritional status. Malnutrition is one of the major factors affecting the postoperative course. We evaluated changes in perioperative nutritional status and risk factors of postoperative severe malnutrition in the GI cancer patients.
  
  
  METHODS
  Nutritional status was prospectively evaluated using patient-generated subjective global assessment (PG-SGA) perioperatively between May and September 2011.
  
  
  RESULTS
  A total of 435 patients were enrolled. Among them, 279 patients had been diagnosed with gastric cancer and 156 with colorectal cancer. Minimal invasive surgery was performed in 225 patients. PG-SGA score increased from 4.5 preoperatively to 10.6 postoperatively (p<0.001). Ten patients (2.3%) were severely malnourished preoperatively, increasing to 115 patients (26.3%) postoperatively. In gastric cancer patients, postoperative severe malnourishment increased significantly (p<0.006). In univariate analysis, old age (>60, p<0.001), male sex (p=0.020), preoperative weight loss (p=0.008), gastric cancer (p<0.001), and open surgery (p<0.001) were indicated as risk factors of postoperative severe malnutrition. In multivariate analysis, old age, preoperative weight loss, gastric cancer, and open surgery remained significant as risk factors of severe malnutrition.
  
  
  CONCLUSIONS
  The prevalence of severe malnutrition among GI cancer patients in this study increased from 2.3% preoperatively to 26.3% after an operation. Old age, preoperative weight loss, gastric cancer, and open surgery were shown to be risk factors of postoperative severe malnutrition. In patients at high risk of postoperative severe malnutrition, adequate nutritional support should be considered.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Severance Hospital Nutritional Support Team, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. jakii@yuhs.ac.
authors.forename: Hongjin
authors.initials: H
authors.lastname: Shim
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Cheong
authors.forename: Kang Young
authors.initials: KY
authors.lastname: Lee
authors.forename: Hosun
authors.initials: H
authors.lastname: Lee
authors.forename: Jae Gil
authors.initials: JG
authors.lastname: Lee
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Noh
mesh_terms: D015179:Colorectal Neoplasms / Q000601:surgery; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D044342:Malnutrition / Q000175:diagnosis; D009752:Nutritional Status; D011183:Postoperative Complications; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000601:surgery
keywords: General surgery; gastrointestinal neoplasm; nutrition assessment