Nutritional Status Deteriorates Postoperatively Despite Preoperative Nutritional Support

Ann Nutr Metab. 2016;68(4):291-7. doi: 10.1159/000447368. Epub 2016 Jun 28.

Abstract

Background/aims: The aim of the current study was to assess the postoperative evolution of nutritional status and to relate it with postoperative outcomes.

Methods: 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%).

Results: 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.

Conclusions: These data suggest continuing nutritional follow-up after the index hospitalization.

Publication types

  • Comparative Study

MeSH terms

  • Arm
  • Body Mass Index
  • Cohort Studies
  • Digestive System Surgical Procedures / adverse effects*
  • Energy Intake
  • Female
  • Humans
  • Male
  • Malnutrition / epidemiology
  • Malnutrition / physiopathology
  • Malnutrition / prevention & control*
  • Malnutrition / therapy
  • Muscle Development
  • Nutrition Assessment
  • Nutritional Status*
  • Nutritional Support*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control*
  • Postoperative Complications / therapy
  • Preoperative Care*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Switzerland / epidemiology
  • Weight Loss