ASSESSMENT OF NUTRITION STATUS IN PREOPERATIVE SURGICAL PATIENT UNDERGOING MAJOR ABDOMINAL SURGERIES AND ITS RELATION TO POSTOPERATIVE OUTCOME
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 12
Abstract
BACKGROUND Abdominal surgery represents a premeditated trauma, which leads to nutritional depletion and its possible related adverse outcomes, especially in malnourished pre-operative patients. Hence, the aim of the study was to assess nutritional status of a cohort of preoperative patients undergoing major gastrointestinal surgery and its relation to post-operative outcome using different nutritional indices. MATERIALS AND METHODS The present study was a prospective observational study. The study group consisted of total of 139 patients undergoing elective abdominal surgeries in the Department of Surgery in Guwahati Medical College and Hospital between 1st July 2016 and 30th June 2017. Nutritional status of all patients was assessed preoperatively with the help of nutritional tools such as PG-SGA, NRI, Serum Albumin, NRS 2002 and MUST. Patients were observed in the post-operative period for specific complications until the period of discharge (By one of the authors who was unaware of the pre-operative nutritional status). To assess the efficacy of the nutritional indices in predicting post-operative complications p value, chi-square, odds ratio, sensitivity, specificity, positive predictive value and negative predictive value were calculated wherever applicable. Study Design- Prospective observational study. RESULTS Out of the 139 patients studied, 6 patients died in early post-operative period due to various reasons. The remaining 133 patients were analysed out of which 49.6%, 53.8%, 36%, 81.9% and 50.4% were found to be malnourished according to PG-SGA, NRI, Serum Albumin, NRS 2002 and MUST respectively. Out of 133 patients, 70 were found to be free of complication. All the tools showed positive correlation on comparing the preoperative nutritional status and post complication rate with a p value < 0.0001 consistently. However, the odds ratio was 17.3, 9.1, 2.8, 87.5 and 15.5 in PG-SGA, NRI, Serum Albumin, NRS 2002 and MUST respectively. CONCLUSION Our study concluded that all of the screening tools accurately help in predicting the post-operative outcome, however, on taking parameters such as sensitivity, specificity and predictive values into account. PG-SGA was found to be superior compared to other screening tools.
Authors and Affiliations
Rakesh Roshan, Ranjit Kumar Deka, Kaushik Vora, Karthik H. K, Aditi Komandur
Keywords
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- EP ID EP412020
- DOI 10.14260/jemds/2018/329
- Views 94
- Downloads 0
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