Prospective Assessment of Malnutrition in Urologic Patients

Karl, Alexander; Rittler, P.; Büchner, Alexander; Fradet, Vincent; Speer, Robert E.; Walther, Sebastian; Stief, G. Christian

doi:10.1016/j.urology.2008.12.037

Cited by 65 publications

(37 citation statements)

References 21 publications

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“…They concluded that the complication rate was higher in malnourished patients (6 of 68 vs 16 of 252) but the study was hampered by several methodological flaws. In our study 51 patients (46%) were at risk for malnutrition, greater than the 33% of urological patients treated with open surgery described by Karl et al 7 In contrast, Roth et al from Bern reported their experience with postoperative parenteral nutritional support in 157 patients undergoing radical cystectomy and found that a risk of malnutrition, defined as NRS 3 or greater, was present in 84 (54%). 16 This shows the wide variation of malnutrition in hospitalized patients upon admission and preoperatively.…”

Section: Discussioncontrasting

confidence: 49%

“…Karl et al recently reported that up to 33% of urological patients who underwent open surgery at a urology department in Germany were at risk for malnutrition (NRS 3 or greater). 7 In addition, recently 2 groups from the United States retrospectively evaluated the effect of preoperative nutritional deficiency on perioperative mortality and overall survival in patients undergoing oncological radical cystectomy or nephrectomy. 8,9 Nutrition deficiency was a strong independent factor for mortality in each study.…”

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confidence: 99%

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926 Are patients at nutritional risk more prone to complications after major urological surgery?

Cerantola¹,

Valerio²,

Hübner³

et al. 2013

European Urology Supplements

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Purpose: The nutritional risk score is a recommended screening tool for malnutrition. While a nutritional risk score of 3 or greater predicts adverse outcomes after digestive surgery, to our knowledge its predictive value for morbidity after urological interventions is unknown. We determined whether urological patients at nutritional risk are at higher risk for complications after major surgery than patients not at nutritional risk. Materials and Methods:We performed a prospective observational study in consecutive patients undergoing major surgery. A priori sample calculation resulted in a study cohort of 220 patients. Interim analysis was planned after 110 patients. The nutritional risk score was assessed preoperatively by a specialized study nurse. Nutritional care was standardized in all patients. Postoperative complications were defined previously using the standardized Dindo-Clavien classification. The primary end point was 30-day morbidity. Univariate and multivariate analysis was performed to identify predictors of complications. Results:The study was discontinued due to significant results after interim analysis. A total of 125 patients were included in analysis from June 2011 to June 2012 and 15 were excluded because of incomplete data. Of 51 patients at nutritional risk 38 (74%) presented with at least 1 complication compared to 28 of 59 controls (47%). Patients at nutritional risk were at threefold risk for compli-cations on univariate and multivariate analysis (OR 3.3, 95% CI 1.3e8.0). Cys-tectomy was the only other predictor of morbidity (OR 10, 95% CI 2e48).Conclusions: Patients at nutritional risk are more prone to complications after major urological procedures. Whether this increased morbidity can be reversed by perioperative nutritional support should be studied.

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Section: Discussioncontrasting

confidence: 49%

mentioning

confidence: 99%

926 Are patients at nutritional risk more prone to complications after major urological surgery?

Cerantola¹,

Valerio²,

Hübner³

et al. 2013

European Urology Supplements

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show abstract

“…219,220 With respect to preoperative nutrition, up to 33% of urology patients undergoing surgery are at nutritional risk. 221 Preoperative malnutrition independently increases the mortality rate, 222 but its impact on morbidity has not been studied. Preoperative oral nutritional support is helpful in patients undergoing major GI procedures, 223 and its role in reducing morbidity and mortality in urology remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Recommendations for the improvement of bladder cancer quality of care in Canada: A consensus document reviewed and endorsed by Bladder Cancer Canada (BCC), Canadian Urologic Oncology Group (CUOG), and Canadian Urological Association (CUA), December 2015

Kassouf

Aprikian

Black

et al. 2016

CUAJ

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This initiative was undertaken in response to concerns regarding the variation in management and in outcomes of patients with bladder cancer throughout centres and geographical areas in Canada. Population-based data have also revealed that real-life survival is lower than expected based on data from clinical trials and/or academic centres. To address these perceived shortcomings and attempt to streamline and unify treatment approaches to bladder cancer in Canada, a multidisciplinary panel of expert clinicians was convened last fall for a two-day working group consensus meeting. The panelists included urologic oncologists, medical oncologists, radiation oncologists, patient representatives, a genitourinary pathologist, and an enterostomal therapy nurse. The following recommendations and summaries of supporting evidence represent the results of the presentations, debates, and discussions. Methodology

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“…Важность предоперационного консультирования пациентов от-носительно ведения в режиме fast track подчеркнута неоднократно [15,16]. Тем не менее на сегодняшний день нет ни одного исследования его роли среди онко-урологических пациентов.…”

Section: Discussionunclassified

Early recovery program in the radical surgical treatment of patients with prostate cancer: Experience of the specialized hospital

Berkut

Рева

Носов

2017

Clinical Nutrition ESPEN

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Prospective Assessment of Malnutrition in Urologic Patients

Cited by 65 publications

References 21 publications

926 Are patients at nutritional risk more prone to complications after major urological surgery?

926 Are patients at nutritional risk more prone to complications after major urological surgery?

Recommendations for the improvement of bladder cancer quality of care in Canada: A consensus document reviewed and endorsed by Bladder Cancer Canada (BCC), Canadian Urologic Oncology Group (CUOG), and Canadian Urological Association (CUA), December 2015

Early recovery program in the radical surgical treatment of patients with prostate cancer: Experience of the specialized hospital

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