The presurgical controlling nutritional status (CONUT) score is independently associated with severe peristomal skin disorders: a single-center retrospective cohort study

Abstract

While nutritional interventions may potentially lower the risk of peristomal skin disorders (PSDs) and their exacerbation, no previous studies have evaluated the relationship between PSDs and nutritional status using the Controlling Nutritional Status (CONUT) score. The purpose of this study was to assess the impact of preoperative nutritional status on stoma health, and determine risk factors for postoperative PSDs, including severe PSDs. A retrospective analysis was performed of 116 consecutive patients with rectal cancer who underwent radical surgery with ileostomy or colostomy creation. PSDs were diagnosed in 32 patients (27.6%); including 10 cases (8.7%) that were defined as severe based on the ABCD-stoma score. Multivariable logistic regression showed that smoking (odds ratio [OR] 3.451, 95% confidence interval [CI] 1.240–9.607, p = 0.018) and ileostomy (OR 3.287, 95% CI 1.278–8.458, p = 0.014) were independent risk factors for PSDs. A separate multivariable logistic regression analysis of risk factors for severe PSDs, found that the only independent risk factor was the CONUT score (OR 10.040, 95% CI 1.191–84.651, p = 0.034). Severe PSDs are associated with preoperative nutritional disorders, as determined by the CONUT score. Furthermore, nutritional disorders may increase the severity of PSDs, regardless of the stoma type.

Effect of continuous nursing on wound infection and quality of life in patients with cancer‐related stoma: A meta‐analysis

“…The methodological quality of the included studies was evaluated independently by two researchers using the risk of bias assessment tool provided in the Cochrane Handbook 6.0. The evaluation criteria were as follows: (1) generation of random sequences; (2) allocation concealment; (3) blinding of intervention providers and participants; (4) blinding of outcome assessors; (5) completeness of outcome data; (6) selective reporting of study results; and (7) other sources of bias. Each criterion was assessed as 'low risk of bias', 'unclear', or 'high risk of bias'.…”

“…Although the surgery effectively prolongs the life expectancy of patients with colorectal cancer, the stoma changes the original physiological function and body image of the patient. It often causes complications, such as stoma stricture, obstruction, and wound infection, which have a significant impact on the life of the patients and impose a heavy psychological burden 5,6 . To improve the postoperative quality of life of patients with stoma and reduce the incidence of postoperative complications, they must continue to receive guidance and assistance from health care professionals after their discharge.…”