Evaluation of nutritional status as an independent predictor of post-operative complications and morbidity after gastro-intestinal surgery

G van der Kroft; M L G Janssen-Heijnen; C L H van Berlo; J L M Konsten

doi:10.1016/j.clnesp.2015.05.005

Evaluation of nutritional status as an independent predictor of post-operative complications and morbidity after gastro-intestinal surgery

Clin Nutr ESPEN. 2015 Aug;10(4):e129-e133. doi: 10.1016/j.clnesp.2015.05.005. Epub 2015 Jun 19.

Authors

G van der Kroft¹, M L G Janssen-Heijnen², C L H van Berlo³, J L M Konsten³

Affiliations

¹ Department of General, Gastrointestinal and Transplant Surgery, Uniklinik Aachen, Aachen, Germany. Electronic address: Gregory.kroft@gmail.com.
² Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands; Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands.
³ Department of Surgery, VieCuri Medical Centre, Venlo, The Netherlands.

PMID: 28531389
DOI: 10.1016/j.clnesp.2015.05.005

Abstract

Background: Nutritional Risk Screening-2002 (NRS-2002) and the Malnutrition Universal Screening Tool (MUST) are screening tools for nutritional risk that have also been used to predict post-operative complications and morbidity, though not all studies confirm the reliability of nutritional screening. Our study aims to evaluate the independent predictive value of nutritional risk screening in addition to currently documented medical, surgical and anesthesiological risk factors for post-operative complications, as well as length of hospital stay.

Methods: This study is a prospective observational cohort study of 129 patients undergoing elective gastro-intestinal-surgery. Patients were screened for nutritional risk upon admission using both MUST and NRS-2002 screening tools. Univariate and multivariate analyses were performed to investigate the independent predictive value of nutritional risk for post-operative complications and length of hospital stay.

Results: MUST ≥2 (OR 2.87; 95% CI 1.05-7.87) and peri-operative transfusion (OR 2.78; 95% CI 1.05-7.40) were significant independent predictors for the occurrence of post-operative complications. Peri-operative transfusion (HR 2.40; 95% CI 1.45-4.00), age ≥70 (HR 1.50; 95% CI 1.05-2.16) and open surgery versus laparoscopic surgery (HR 1.39; 95% CI 0.94-2.05) were independent predictors for increased length of hospital stay, whereas American Society of Anesthesiology Score (ASA) and MUST were not.

Conclusion: Nutritional risk screening (MUST ≥2) is an independent predictor for post-operative complications, but not for increased length of hospital stay.

Keywords: Gastrointestinal surgery; Length of hospital stay; MUST; NRS-2002; Nutritional risk screening; Postoperative complications.