Effects of Preoperative Malnutrition on Postoperative Surgical Outcomes and Quality of Life of Elderly Patients with Periampullary Neoplasms: A Single-Center Prospective Cohort Study
Gut and Liver
;
: 690-697, 2019.
Article
in English
| WPRIM
| ID: wpr-763881
ABSTRACT
BACKGROUND/AIMS:
We investigated the effect of preoperative malnutrition on postoperative surgical outcomes in elderly patients undergoing pancreatoduodenectomy for periampullary neoplasms.METHODS:
This prospective cohort study enrolled 154 patients aged ≥65 years with periampullary neoplasms. Using the Mini Nutritional Assessment tool, patients were categorized into three groups according to their preoperative nutritional status well-nourished (13.0%), at-risk-of-malnutrition (59.7%), and malnourished (27.3%).RESULTS:
Significant intergroup differences were observed in preoperative body mass index (25.6±2.4 kg/m² [well-nourished] vs 23.4±2.6 kg/m² [at-risk-of-malnutrition] vs 21.1±2.8 kg/m² [malnourished], p<0.001). The overall morbidity significantly differed between the well-nourished and malnourished groups (20% vs 50.0%, p=0.024). The rates of clinically significant postoperative pancreatic fistula were significantly different among groups (p=0.035). Univariate and multivariate analyses showed that the at-risk-of-malnutrition or malnourished status (hazard ratio [HR], 3.45; p=0.037) and intraoperative blood loss (HR, 1.01; p=0.040) significantly affected the overall postoperative morbidity in elderly patients.CONCLUSIONS:
Before surgery, 87.0% of patients were classified into the at-risk-of-malnutrition or malnourished group. Compared with well-nourished patients, patients with nutritional issues showed a higher overall surgical morbidity. Improved preoperative nutritional status leads to favorable surgical outcomes in elderly patients.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Quality of Life
/
Body Mass Index
/
Nutrition Assessment
/
Nutritional Status
/
Multivariate Analysis
/
Prospective Studies
/
Cohort Studies
/
Pancreatic Fistula
/
Pancreaticoduodenectomy
/
Malnutrition
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Humans
Language:
English
Journal:
Gut and Liver
Year:
2019
Type:
Article
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