title: Malnutrition at the time of surgery affects negatively the clinical outcome of critically ill patients with gastrointestinal cancer.
abstract: BACKGROUND
  Malnutrition is a frequent concomitant of surgical illness, especially in gastrointestinal cancer surgery. The aim of the study was to assess the prevalence of malnutrition in the GI cancer patients and its relation with clinical outcome. We also examined associations between the energy balance and clinical outcomes in these patients.
  
  
  METHODS
  Prospective study on 694 surgical patients treated in the ICU of the UHC of Tirana. Patients were divided into well-nourished and malnourished groups according to their nutritional status. Multiple regression analysis was used to analyze the effect of malnutrition and cumulated energy balance on clinical outcome.
  
  
  RESULTS
  The prevalence of pre-operative malnutrition was 65.3% for all surgical patients and 84.9% for gastrointestinal cancer patients. Malnutrition, as analyzed by a multivariate logistic regression model, is an independent risk factor for higher complications, infections, and mortality, longer stay in the ventilator and ICU. Also this model showed that cumulated energy balance correlated with infections, and mortality and was independently associated with the length ventilator and ICU stay.
  
  
  CONCLUSIONS
  This study shows that malnutrition is a significant problem in surgical patients, especially in patients with gastrointestinal cancer. Malnutrition and cumulated energy deficit in gastro-intestinal surgery patients with malignancy is an independent risk factor on increased post-operative morbidity and mortality.
authors.affiliation: Faculty of Medical Technical Sciences, University of Medicine, Tirana, Albani.
authors.forename: Vjollca
authors.initials: V
authors.lastname: Shpata
authors.affiliation: Faculty of Medical Technical Sciences, University of Medicine, Tirana, Albani.
authors.forename: Xhensila
authors.initials: X
authors.lastname: Prendushi
authors.affiliation: Faculty of Medical Technical Sciences, University of Medicine, Tirana, Albani.
authors.forename: Manika
authors.initials: M
authors.lastname: Kreka
authors.affiliation: Faculty of Medical Technical Sciences, University of Medicine, Tirana, Albani.
authors.forename: Irena
authors.initials: I
authors.lastname: Kola
authors.affiliation: Faculty of Medical Technical Sciences, University of Medicine, Tirana, Albani.
authors.forename: Floreta
authors.initials: F
authors.lastname: Kurti
authors.affiliation: Department of Anesthesia and Intensive Care, Faculty of Medicine, University of Medicine, Albania, University Hospital Center "Mother Teresa", Tirana.
authors.forename: Ilir
authors.initials: I
authors.lastname: Ohri
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: cumulated energy deficit; malign disease; morbidity; mortality; nutritional status; surgical critically ill