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Malnutrition and pancreatic surgery: Prevalence and outcomes

Authors

  • Marco La Torre MD,

    Corresponding author
    1. Department of General Surgery, University of Rome “La Sapienza,” St. Andrea Hospital, Via di Grottarossa, Rome, Italy
    • Faculty of Medicine and Psychology, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, University of Rome “La Sapienza”, St. Andrea Hospital, Via di Grottarossa, 1035-39, 00189 Rome, Italy. Fax: +39-0633775322.===

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  • Vincenzo Ziparo MD,

    1. Department of General Surgery, University of Rome “La Sapienza,” St. Andrea Hospital, Via di Grottarossa, Rome, Italy
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  • Giuseppe Nigri MD,

    1. Faculty of Medicine and Psychology, Department of Hepato-Biliary and Pancreatic Surgery, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, University of Rome “La Sapienza,” St. Andrea Hospital, Via di Grottarossa, Rome, Italy
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  • Marco Cavallini MD,

    1. Department of General Surgery, University of Rome “La Sapienza,” St. Andrea Hospital, Via di Grottarossa, Rome, Italy
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  • Genoveffa Balducci MD,

    1. Department of General Surgery, University of Rome “La Sapienza,” St. Andrea Hospital, Via di Grottarossa, Rome, Italy
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  • Giovanni Ramacciato MD

    1. Faculty of Medicine and Psychology, Department of Hepato-Biliary and Pancreatic Surgery, Surgical Department of Clinical Sciences, Biomedical Technologies and Translational Medicine, University of Rome “La Sapienza,” St. Andrea Hospital, Via di Grottarossa, Rome, Italy
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  • Conflicts of Interest: The authors declare no conflicts of interest.

Abstract

Background

Pancreatic surgery is associated with severe postoperative morbidity. Identification of patients at high risk may provide a way to allocate resources objectively and focus care on those patients in greater need. The Authors evaluate the prevalence of malnutrition and its effect on the postoperative morbidity of patients undergoing pancreatic surgery for malignant tumors.

Methods

Data were collected from 143 patients who had undergone pancreatic resection for cancer. Prevalence of malnutrition was evaluated by several validated screening tools and correlated to the incidence of surgical site infection, overall morbidity, mortality, and hospital stay.

Results

Overall, 88% of patients were at medium-high risk of malnutrition. Patients at high risk of malnutrition presented a fourfold longer postoperative hospitalization period and a higher morbidity rate (53.2%) than those patients at low risk of malnutrition. Malnutrition, evaluated by MUST and NRI, was an independent predictor of overall morbidity using multivariate analysis (P = 0.00145, HR = 2.6581, 95% CI = 1.3589–8.5698, and P = 0.07129, HR = 1.9953, 95% CI = 0.9723–13.548, respectively).

Conclusion

Malnutrition is a relevant predictor of post-operative morbidity and mortality after pancreatic surgery. Patients underwent pancreatic resection for malignant tumors are usually malnourished. Preoperative malnutrition screening is mandatory in order to assess the risk and to treat the malnutrition. J. Surg. Oncol. 2013;107:702–708. © 2012 Wiley Periodicals, Inc.

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