Impact of nutritional screening index on perioperative morbidity after colorectal cancer surgery as a independent predictive factor
- Author:
Yoon Hyung KANG
1
;
Ji Won PARK
;
Seung Bum RYOO
;
Seung Yong JEONG
;
Kyu Joo PARK
Author Information
- Publication Type:Original Article
- Keywords: Colorectal cancer; Colectomy; Malnutrition; Screening; Morbidity
- MeSH: Cholesterol; Colectomy; Colorectal Neoplasms; Colorectal Surgery; Humans; Length of Stay; Lymphocyte Count; Male; Malnutrition; Mass Screening; Methods; Multivariate Analysis; Nutrition Assessment; Nutritional Status; Nutritional Support; Risk Factors; Seoul
- From: Korean Journal of Clinical Oncology 2017;13(2):118-125
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Nutrition status is an important factor for perioperative morbidity in cancer surgery. The aim of this study was to evaluate the impact of the malnutrition risk, determined by Seoul National University Hospital-nutrition screening index (SNUH-NSI), on operative morbidity after colorectal surgery for cancer.METHODS: This study enrolled 2,462 patients who had undergone colectomy for initially diagnosed colorectal cancer at Seoul National University Hospital from January 2011 to December 2014. We collected general patient information, SNUH-NSI and prognostic nutritional index (PNI) at administration and related parameters (serum albumin, cholesterol, total lymphocyte counts, hemoglobin and body mass index), operative method, hospital stay and operative morbidity.RESULTS: Patients' mean age was 62.12 years, and 423 patients (17.18%) were rated as severe malnutrition risk. Patients with high risk of malnutrition by SNUH-NSI or PNI, men, higher American Society of Anesthesiologists (ASA) class, palliative operation, and higher stage showed higher operative morbidity (P < 0.05). On multivariate analysis, significant independent risk factors for operative morbidity were severe malnutrition by SNUH-NSI (odds ratio [OR], 1.868; 95% confidence interval [CI], 1.429–2.442; P < 0.001) or PNI (OR, 1.596; 95% CI, 1.258–2.025; P < 0.001), men (OR, 1.483; 95% CI, 1.174–1.876; P=0.001), or high ASA class (OR, 1.782; 95% CI, 1.136–2.795; P=0.012).CONCLUSION: Overall nutritional status, rather than single data, shows significant association with postoperative morbidity in patients who underwent colectomy. Especially severe malnutrition determined by SNUH-NSI, is an independent risk factor for perioperative morbidity. Nutritional support to severely malnourished patient by SNUH-NSI is expected to be effective in preventing complications after colectomy of colorectal carcinoma patients.
