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Limitations of nutritional assessment in predicting the outcome of colorectal operations

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Diseases of the Colon & Rectum

Abstract

The value of preoperative nutritional assessment in predicting postoperative morbidity and mortality is controversial. To evaluate the predictive value of preoperative nutritional status, the courses of 100 consecutive patients undergoing colorectal operations were studied prospectively. Subnormal findings for triceps-skin-fold thickness (TSF) and percentage of ideal body weight were associated with a significantly higher complication rate, but occurred so infrequently in our patients that the routine use of these tests is not recommended. Subnormal values for commonly obtained nutritional variables may not justify delay of operation for nutritional repletion.

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References

  1. Baker JP, Detsky AS, Wesson DE, et al. Nutritional assessment: a comparison of clinical judgment and objective measurements. N Engl J Med 1982;306:969–72.

    Article  PubMed  CAS  Google Scholar 

  2. Eisenberg D, Silberman H, Maryniuk J, Ryan J, Shoffler R, Weiss J. Inapplicability of the prognostic nutritional index in critically ill patients. Surg Forum 1981;32:109–11.

    Google Scholar 

  3. Forse RA, Shizgal HM. The assessment of malnutrition. Surgery 1980;88:17–24.

    PubMed  CAS  Google Scholar 

  4. Miller SF, Finley RK Jr, Morath M. Nutritional assessment and support: scientific inquiry? (editorial). J Trauma 1983;23:68–9.

    PubMed  CAS  Google Scholar 

  5. Ryan JA Jr, Taft DA. Preoperative nutritional assessment does not predict morbidity and mortality in abdominal operations. Surg Forum 1980;31:96–8.

    Google Scholar 

  6. Turner WW Jr, Landreneau RJ, Toler GF, Meier DE, Thal ER. How accurate is nutritional risk classification? Surg Forum 1982;33:107–9.

    Google Scholar 

  7. Mullen JL, Buzby GP, Matthews DC, Smale BF, Rosato EF. Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. Ann Surg 1980;192:604–13.

    Article  PubMed  CAS  Google Scholar 

  8. Heatley RV, Williams RHP, Lewis MH. Pre-operative intravenous feeding: a controlled trial. Postgrad Med J 1979;55:541–5.

    PubMed  CAS  Google Scholar 

  9. Holter AR, Fischer JE. The effects of perioperative hyperalimentation on complications in patients with carcinoma and weight loss. J Surg Res 1977;23:31–4.

    Article  PubMed  CAS  Google Scholar 

  10. McIlrath DC, van Heerden JA, Edis AJ, Dozois RR. Closure of abdominal incisions with subcutaneous catheters. Surgery 1976; 80:411–5.

    PubMed  CAS  Google Scholar 

  11. Grant JP, Custer PB, Thurlow J. Current techniques of nutritional assessment. Surg Clin North Am 1981 June; 61: 437–63.

    PubMed  CAS  Google Scholar 

  12. Dreblow DM, Anderson CF, Moxness K. Nutritional assessment of orthopedic patients. Mayo Clin Proc 1981;56:51–4.

    PubMed  CAS  Google Scholar 

  13. Bistrian BR, Blackburn GL, Hallowell E, Heddle R. Protein status of general surgical patients. JAMA 1974;230:858–60.

    Article  PubMed  CAS  Google Scholar 

  14. Hickman DM, Miller RA, Rombeau JL, Twomey PL, Frey CF. Serum albumin and body weight as predictors of postoperative course in colorectal cancer. JPEN 1980;4:314–6.

    CAS  Google Scholar 

  15. Irvin TT, Goligher JC. Aetiology of disruption of intestinal anastomoses. Br J Surg 1973;60:461–4.

    PubMed  CAS  Google Scholar 

  16. Mullen JL, Gertner MH, Buzby GP, Goodhart GL, Rosato EF. Implications of malnutrition in the surgical patient. Arch Surg 1979;114:121–5.

    PubMed  CAS  Google Scholar 

  17. Kaminski MV Jr, Fitzgerald MJ, Murphy RJ, et al. Correlation of mortality with serum transferrin and anergy (abstr.). JPEN 1977;1:27A.

    Google Scholar 

  18. Meakins JL, Pietsch JB, Bubenick O, et al. Delayed hypersensitivity: indicator of acquired failure of host defenses in sepsis and trauma. Ann Surg 1977;186;241–9.

    Article  PubMed  CAS  Google Scholar 

  19. Seltzer MH, Bastidas JA, Cooper DM, Engler P, Slocum B, Fletcher HS. Instant nutritional assessment. JPEN 1979;3:157–9.

    CAS  Google Scholar 

  20. Buzby GP, Mullen JL, Matthews DC, Hobbs CL, Rosato EF. Prognostic nutritional index in gastrointestinal surgery. Am J Surg 1980;139:160–6.

    Article  PubMed  CAS  Google Scholar 

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Thompson, J.S., Beart, R.W. & Anderson, C.F. Limitations of nutritional assessment in predicting the outcome of colorectal operations. Dis Colon Rectum 29, 488–491 (1986). https://doi.org/10.1007/BF02562599

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  • DOI: https://doi.org/10.1007/BF02562599

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