title: Nutritional Status Deteriorates Postoperatively Despite Preoperative Nutritional Support.
abstract: The aim of the current study was to assess the postoperative evolution of nutritional status and to relate it with postoperative outcomes.
  
  
  
  Demographic, surgical and nutritional parameters were assessed 10 days preoperatively (d-10) and 30 days postoperatively (d30) in 146 patients. Risk factors responsible for perioperative (>5% between d-10 and d30) weight loss were identified. Overall, severe (Clavien 3-5) and infectious complications were compared in patients with and without perioperative weight loss (>5%).
  
  
  
  Nutritional status worsened beyond the postoperative period as reflected by decreasing weight (67 ± 13 kg at d-10 vs. 63 ± 13 kg at d30, p < 0.001), body mass index (23.4 ± 4 vs. 22.2 ± 4 kg/m2, p < 0.001) and mid upper-arm muscle circumference (MAMC, 241 ± 32 vs. 232 ± 30 mm, p < 0.001). Fifty-two patients (46%) lost >5% of their body weight between d-10 and d30. Patients who presented overall (63 vs. 36%, p = 0.004) and major (27 vs. 10%, p = 0.016) postoperative complications were at significantly higher risk to deteriorate postoperative nutritional status. Multivariate analysis identified low preoperative lean body mass (OR 3.2; 95% CI 1.2-8.9, p = 0.023) and low preoperative MAMC (OR 2.5; 95% CI 0.9-6.8, p = 0.066) as independent risk factors for perioperative weight loss.
  
  
  
  These data suggest continuing nutritional follow-up after the index hospitalization.
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: Fabian
authors.initials: F
authors.lastname: Grass
authors.forename: Michael
authors.initials: M
authors.lastname: Benoit
authors.forename: Pauline
authors.initials: P
authors.lastname: Coti Bertrand
authors.forename: Josep
authors.initials: J
authors.lastname: Sola
authors.forename: Markus
authors.initials: M
authors.lastname: Schäfer
authors.forename: Nicolas
authors.initials: N
authors.lastname: Demartines
authors.forename: Martin
authors.initials: M
authors.lastname: Hübner
mesh_terms: D001132:Arm; D015992:Body Mass Index; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D002149:Energy Intake; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D024510:Muscle Development; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support; D011183:Postoperative Complications / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D011300:Preoperative Care; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013557:Switzerland / Q000453:epidemiology; D015431:Weight Loss