Malnutrition associated with an increased risk of postoperative complications following hepatectomy in patients with hepatocellular carcinoma

Huang, Tzu-Hao; Hsieh, Ching‐Chuan; Kuo, Liang-Mou; Chang, Chia Chin; Chen, Chun‐Han; Chi, Ching‐Chi; Liu, Chin-Hua

doi:10.1016/j.hpb.2019.01.003

Cited by 43 publications

(34 citation statements)

References 25 publications

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“…Furthermore, the length of hospital stay was significantly shorter in the immunonutrition group. Studies have reported that frequent complications and malnutrition were associated with longer hospital stay [43]. In our study, decreased postoperative complications and improvement of nutritional status may have led to shortening of the length of hospitalization.…”

Section: Discussionsupporting

confidence: 59%

Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2020

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Background: The effect of immunonutrition in patients undergoing hepatectomy remains unclear. This meta-analysis aimed to assess the impact of immunonutrition on postoperative clinical outcomes in patients undergoing hepatectomy. Methods: A literature search of PubMed, Cochrane Library, Web of Science, and Embase databases was performed to identify all randomized controlled trials (RCTs) exploring the effect of perioperative immunonutrition in patients undergoing hepatectomy until the end of March 10, 2020. Quality assessment and data extraction of RCTs were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software. Results: Nine RCTs involving a total of 966 patients were finally included. This meta-analysis showed that immunonutrition significantly reduced the incidences of overall postoperative complications (OR = 0.57, 95% CI: 0.34–0.95; p = 0.03), overall postoperative infectious complications (OR = 0.53, 95% CI: 0.37–0.75; p = 0.0003), and incision infection (OR = 0.50, 95% CI: 0.28–0.89; p = 0.02), and it shortened the length of hospital stay (MD = −3.80, 95% CI: −6.59 to −1.02; p = 0.007). There were no significant differences in the incidences of pulmonary infection (OR = 0.60, 95% CI: 0.32–1.12; p = 0.11), urinary tract infection (OR = 1.30, 95% CI: 0.55–3.08; p = 0.55), liver failure (OR = 0.54, 95% CI: 0.23–1.24; p = 0.15), and postoperative mortality (OR = 0.69, 95% CI: 0.26–1.83; p = 0.46). Conclusion: Given its positive impact on postoperative complications and the tendency to shorten the length of hospital stay, perioperative immunonutrition should be encouraged in patients undergoing hepatectomy.

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Section: Discussionsupporting

confidence: 59%

Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2020

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“…Considering preoperative patient factors and their associations with mortality, the odds of non-survival increased with increasing CI and decreasing BCS. Previous research in people have found associations between malnutrition and presence of comorbidities with increasing postoperative complications and death [14,37]. It is also worth noting that most patient with CI 2 in the present study had a diagnosis of chronic enteropathy, and a relationship between high CI and low BCS that was not statistically evaluated cannot be excluded.…”

Section: Discussionmentioning

confidence: 56%

Perioperative Outcome in Dogs Undergoing Emergency Abdominal Surgery: A Retrospective Study on 82 Cases (2018-2020)

Fages¹,

Soler²,

Fernandez‐Salesa³

et al. 2021

Preprint

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Emergency abdominal surgery carries high morbidity and mortality rates in human medicine; however, there is less evidence characterizing the outcome of these surgeries as a single group in dogs. The aim of the study was to characterize the clinical course, associated complications and outcome of dogs undergoing emergency abdominal surgery. A retrospective study was conducted. Dogs undergoing emergency laparotomy were included in the study. Logistic regression analysis was performed to identify variables correlated with death and complications. Eighty-two dogs were included in the study. The most common reason for surgery was gastrointestinal foreign body. Overall 15-day mortality rate was 20.7% (17/82). Median (range) length of hospitalization was 3 (0.5 - 15) days. Of the 82 patients, 24 (29.3%) developed major complications and 66 (80.5%) minor complications. Perioperative factors significantly associated with death included tachycardia (P &lt; 0.001), hypothermia (P &lt; 0.001), lactate acidosis (P &lt; 0.001), shock index &gt; 1 (P &lt; 0.001), leukopenia (P &lt; 0.001), thrombocytopenia (P &lt; 0.001) at admission; intraoperative hypotension (P &lt; 0.001) and perioperative use of blood products (P &lt; 0.001). The results of this study suggest that mortality and morbidity rates after emergency abdominal surgery in dogs are high.

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“…It is inexpensive and relatively easy to execute, and can detect nutritional changes in its early stages, allowing for early nutritional interventions. PG-SGA correlates well with other nutritional assessment methods [12] and malnutrition identified by this method has been shown to be a good predictor of unfavourable clinical outcomes in cancer patients [13,14].…”

Section: Methodsmentioning

confidence: 80%

“…That study also showed that as the treatment progressed, other undesired effects also occurred, including deteriorated nutritional status, as identified by the Mini Nutritional Assessment tool [19]. A study recruiting 60 cancer patients aged in average 61.9 years receiving radiation therapy identified a significant correlation between changes in PG-SGA scores (p < 0.001) and changes in QoL scores (p = 0.003) amongst the patients that either improved (5% of participants), maintained (56.7%) or deteriorated (33.3%) their nutritional status after 4 weeks of treatment [14]. The researchers' regression analysis revealed that 26% of the QoL change variation was attributed to changes in the PG-SGA scores [20].…”

Section: Discussionmentioning

confidence: 99%

A poorer nutritional status impacts quality of life in a sample population of elderly cancer patients

Rios¹,

Oliveira

Costa³

et al. 2021

Health Qual Life Outcomes

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Rationale Quality of Life (QoL) is impaired in cancer, and the elderly are particularly vulnerable to malnutrition. A diagnosis of cancer in elderly patients further exacerbates risks of negative health outcomes. Here we investigated associations between QoL and nutritional status in a sample population of mostly socially deprived elderly cancer patients. Method 432 cancer patients were recruited for this cross-sectional study at point of admission to a tertiary referral hospital for cancer treatment. Patient-generated subjective global assessment (PG-SGA) assessed nutritional status. Functional assessment of cancer therapy- general (FACT-G) quantified QoL. Relationship between PG-SGA and QoL was assessed by Spearman correlation. PG-SGA outcomes were compared against FACT-G scores employing Mann–Whitney test. Bivariate Linear Regression Model was employed to investigate influences of sociodemographic, clinical and nutritional status upon QoL. Results 37.5% of participants were malnourished or at risk. 39% were illiterate and 54.6% had family income lower than minimum wage. Malnourished patients showed lower FACT-G scores (76.8 vs. 84.7; p = 0.000). Poor nutritional diagnosis was inversely correlated with all QoL domains. Bivariate regression analysis showed that lower PG-SGA scores (βo = − 1.00; p = 0.000) contributed to FACT-G score deterioration, the male gender showed better QoL scores, and other clinical and sociodemographic variables did not show relationship. Conclusion Poorer nutritional status was significantly associated with worsened physical, social, emotional and functional well-being QoL domains in elderly cancer patients. Poorer nutritional status is an independent risk factor for worsened QoL. Future policies aimed at particularly vulnerable populations may improve QoL and health outcomes.

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Malnutrition associated with an increased risk of postoperative complications following hepatectomy in patients with hepatocellular carcinoma

Cited by 43 publications

References 25 publications

Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Perioperative Outcome in Dogs Undergoing Emergency Abdominal Surgery: A Retrospective Study on 82 Cases (2018-2020)

A poorer nutritional status impacts quality of life in a sample population of elderly cancer patients

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