Determinants of malnutrition and post-operative complications in hospitalized surgical patients.
The study aimed to determine the nutritional status (NS) of hospitalized surgical patients and investigate a possible association between NS and type of disease, type of surgery and post-operative complications. The gender, age, disease, surgery, complications, length of hospital stay, number of medications, laboratory test results, and energy intake of 388 hospitalized surgical patients were recorded. NS was determined by classical anthropometry. The inclusion criteria were: nutritional status assessment done within the first 24 hours of admission, age ≥ 20 years, and complete medical history. Univariate and multiple Cox's regression analyses were employed to determine which variables were possible risk factors of malnutrition and complications. Malnutrition was more common in males (p=0.017), individuals aged 70 to 79 years (p=0.000), and individuals with neoplasms and digestive tract diseases (p=0.000). Malnourished individuals had longer hospital stays (p=0.013) and required more medications (p=0.001). The risk of malnutrition was associated with age and disease. Individuals aged 70 years or more had a two-fold increased risk of malnutrition (p=0.014; RR=2.207; 95% CI 1.169-4.165); those with neoplasms (p=0.008; RR=14.950; 95% CI 2.011-111.151) and those having digestive tract diseases (p=0.009; RR=14.826; 95% CI 1.939-113.362) had a 14-fold increased risk of malnutrition. Complications prevailed in older individuals (p=0.016), individuals with longer hospital stays (p=0.007), and individuals who died (p=0.002). The risk of complications was associated with age and BMI. In the present study, the risk of malnutrition was associated with age and type of disease; old age and low BMI may increase complications.
School of Nutrition, Clinical Nutrition, PUC-Campinas-SP, Brazil.
Vânia Aparecida
VA
Leandro-Merhi
School of Medicine, Surgery Department, PUC-Campinas-SP, Brazil.
José Luiz Braga
JL
de Aquino
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001938:Brazil / Q000453:epidemiology; D002149:Energy Intake; D005260:Female; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000601:surgery; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000601:surgery; D015596:Nutrition Assessment; D009752:Nutritional Status; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D057234:Preoperative Period; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D013514:Surgical Procedures, Operative
Brazil; Complications; Hospitalized surgical patients; Malnutrition; Nutritional status