Impact of preoperative malnutrition, based on albumin level and body mass index, on operative outcomes in patients with pancreatic head cancer

J Hepatobiliary Pancreat Sci. 2021 Dec;28(12):1069-1075. doi: 10.1002/jhbp.858. Epub 2020 Nov 23.

Abstract

Background: To investigate whether preoperative malnutrition in patients who underwent curative pancreaticoduodenectomy (PD) in pancreatic head cancer correlated with short-term outcomes.

Methods: This study was a retrospective review of medical records from January 2004 to December 2018. Preoperative malnutrition was defined as body mass index (BMI) <18.5 kg/m2 , or hypoalbuminemia with serum albumin level < 3.5 g/dL within 30 days before surgery.

Results: Of the 289 eligible patients, 60 patients (20.7%) were classified as the malnutrition group. The estimated blood loss (EBL, mL) (964.1 ± 879.7 vs 597.7 ± 501.7, P = .044) and transfusion rate (51.7% vs 18.8%, P < .001) was significantly higher in the malnutrition group than no-malnutrition group. The hospital stay (days) (20.5 ± 12.2 vs 18.1 ± 13.6, P = .05) was significantly longer in the malnutrition group. The open conversion rate (45.4% vs 6.67%, P < .001) and major complication rate (36.7% vs 21.8%, P = .032) was significantly higher in the malnutrition group. In multivariate analysis, preoperative malnutrition was found to be the predictor of postoperative complication (HR 1.971 95% confidence interval 1.071-3.624, P = .029).

Conclusion: Preoperative malnutrition in patients who underwent curative PD for pancreatic head cancer is associated with adverse short-term outcomes.

Keywords: albumin; body mass index; malnutrition; pancreatectomy; pancreatic cancer.

MeSH terms

  • Albumins
  • Body Mass Index
  • Humans
  • Malnutrition* / diagnosis
  • Malnutrition* / epidemiology
  • Malnutrition* / etiology
  • Pancreatic Neoplasms* / complications
  • Pancreatic Neoplasms* / surgery
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Risk Factors

Substances

  • Albumins