PRE-SURGICAL NUTRITIONAL STATUS AND SURGICAL COMPLICATIONS IN PATIENTS WITH DIGESTIVE AND HEAD AND NECK CANCER

Isabel Ruivo; Carolina Castro; Ana Gonçalves; Paula Alves; Daniel Moreira-Gonçalves; Lúcio Lara Santos

doi:10.34635/rpc.931

Isabel Ruivo Nutrition Service, Portuguese Institute of Oncology, Porto, Portugal
Carolina Castro Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal
Ana Gonçalves Nutrition Service, Portuguese Institute of Oncology, Porto, Portugal
Paula Alves Nutrition Service, Portuguese Institute of Oncology, Porto, Portugal
Daniel Moreira-Gonçalves Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), Porto, Portugal http://orcid.org/0000-0002-7404-7405
Lúcio Lara Santos Experimental Pathology and Therapeutics Group, Portuguese Institute of Oncology, Porto, Portugal; Surgical Oncology Department, Portuguese Institute of Oncology, Porto, Portugal; Surgical Intermediate Care Unit, Portuguese Institute of Oncology, Porto, Portugal http://orcid.org/0000-0002-7404-7405

Abstract

Introduction: Malnutrition is present in 40-50% of surgical patients upon hospital admission and is one of the most important factors influencing post-surgical morbidity and mortality. It is important to establish routines to identify and monitor patients at nutritional risk nutritional, to start early nutritional therapy, ideally in the pre-surgical phase. The aim of this study was to evaluate the association between pre-surgical nutritional status and postoperative complications and assess the nutritional assessment tool with the best prognostic value for post-surgical complications, in patients referred to surveillance in intermediate and intensive care units during surgical planning.

Methods: We recruited patients at the Digestive Pathology and Head and Neck Units, referred for surgery and signaled at the anesthesia consultation for post-surgical surveillance in Intermediate or Intensive Care, from August to December 2016, at the Portuguese Institute of Oncology of Porto, Francisco Gentil, EPE. Clinical and demographic data were collected from the clinical process of the patients. Risk and nutritional status assessment was performed in the first 24 hours of patient’s admission to hospital using the PG-SGA and NRI. Data analysis was performed using the SPSS 23.0 statistical program.

Results: We included 97 patients, 62 with digestive malignancies and 35 with head and neck malignant tumors. The prevalence of pre-surgical malnutrition was 51.2% and 33%, as assessed by NRI and PG-SGA, respectively. Nutritional status, as assessed by NRI was associated with postoperative complications and length of hospital stay. Nutritional status and lack of nutritional support were also associated with greater odds of prolonged hospitalizations (>10 days).

Conclusion: The odds of developing post-surgical complications was about 3 times higher if the patient is malnourished or at risk of malnutrition, as assessed by NRI.

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