Prospective study to evaluate the prognostic value of different nutritional assessment scores in liver surgery: NURIMAS Liver (DRKS00006340)

Abstract

Background: Malnutrition is recognised as a preoperative risk factor for patients undergoing hepatic resection. It is important to identify malnourished patients and take preventive therapeutic action before surgery. However, there is no evidence regarding which existing nutritional assessment score (NAS) is best suited to predict outcomes of liver surgery.Methods: All patients scheduled for elective liver resection at the surgical department of the University Hospital of Heidelberg and the Municipal Hospital of Karlsruhe were screened for eligibility. Twelve NASs were calculated before operation, and patients were categorised according to each score as being either at risk or not at risk for malnutrition. The association of malnutrition according to each score and occurrence of at least one major complication was the primary endpoint, which was achieved using a multivariate logistic regression analysis including established risk factors in liver surgery as covariates.Results: The population consisted of 182 patients. The percentage of patients deemed malnourished by the NAS varied among the different scores, with the lowest being 2.20% (Mini Nutritional Assessment) and the highest 52.20% (Nutritional Risk Classification). Forty patients (22.0%) had a major complication. None of the scores were significantly associated with major complications.Conclusions: None of the twelve investigated NAS defined a state of malnutrition that was independently associated with postoperative complications. Other means of measuring malnutrition in liver surgery should be investigated prospectively.

Application of NRS2002 in Preoperative Nutritional Screening for Patients with Liver Cancer

“…(1) All the patients received routine examination. (2) e patients received indocyanine green excretive test with 15-minute retention and other methods to evaluate their liver function [7,8]. (3) e patients underwent imaging examinations, including MRI examination and ultrasound examination to observe the tumor size, location, and other information and to determine whether extrahepatic metastasis occurred.…”

A Sarcopenia-Based Prediction Model for Postoperative Complications of ex vivo Liver Resection and Autotransplantation to Treat End-Stage Hepatic Alveolar Echinococcosis

“…In modern surgical operations, surgeons and researchers pay increasing attention to the role of nutritional status in the preoperative assessment, and malnutrition has been proven to be a risk factor for postoperative complications. 12 , 13 Sarcopenia, a malnutrition-related muscle disease characterized by low muscle strength, low muscle quantity and quality and poor physical performance, mainly occurs in older people and is possibly caused by disordered energy metabolism. 14 Several studies have reported that sarcopenia, myosteatosis, visceral adiposity and other malnutrition-related indicators play vital roles in the development of postoperative complications.…”

A new sarcopenia score prognostic for postoperative complications in hepatic alveolar echinococcosis: a multicenter retrospective study

“…Malnutrition is considered to be a preoperative risk factor for adverse postoperative outcomes (8,9). Sarcopenia is also considered a malnutrition syndrome characterized by the progressive loss of skeletal muscle mass and strength and impaired muscular function that is caused by decreased protein synthesis and disturbed energy metabolism (10).…”

“…However, the impacts of the above factors on the postoperative complications of liver resection in HAE patients remain unknown. Furthermore, Pascal et al found that the existing nutritional screening tools did not show a good prediction ability of the postoperative complications of liver resection in a prospective study (9). Therefore, it is necessary to establish a new nutrition score using other methods to predict complications after liver resection for HAE.…”

“…P=0.006), white blood cell (WBC) count variable (6.07×10 9 vs. 6.745×109 /L, P=0.017), total bilirubin variable (7.8 vs. 10.15 μmol/L, P=0.036), PMI variable (4.18 vs. 7.04 cm 2 /m 2 , P<0.001), SMI variable (37.02 vs. 45.01 cm 2 /m 2 , P<0.001), VSR variable (0.40 vs. 0.32 cm 2 /cm 2 , P=0.026), IMAC variable (−0.51 vs. −0.56, P<0.001) and hospital stay (14 vs.11.5 days, P=0.001). In addition, patients with sarcopenia type A had a significantly different 90day mortality rate (4.76% vs. 0.59%; P=0.029), as listed in Table 2.…”