Preoperative Nutritional Assessment of The Patients Undergoing Major Gastrointestinal Surgery and Their Immediate Postoperative Outcome

NCT04039035 | Completed DMC

• 1 other identifier: 788/2072/73
• Study Type: observational
• Target: 134
• Locations: 1 country
• Sites: 1

Brief Summary

It was a prospective observational study, where preoperative nutritional status and early postoperative complications \<30 days (infectious or noninfectious) were studied. The patients admitted between July 2015 to May 2017, who underwent major GI surgeries were included in the study. The study was designed to check if BMI and NRI can predict the postoperative outcomes in these patients.

Conditions

Preoperative Nutritional Status and the Postoperative Outcome

Keywords

Nutritional Risk Index; Body mass Index; Postoperative Complications; Length of Hospital Stay and Cost.

Outcome Measures

Primary Outcomes (1)

• Infectious and noninfectious complication

  Correlation between NRI/BMI and postoperative complications (infectious and noninfectious). The NRI is calculated using the formula: NRI = (15.9 × serum albumin g/L) + (41.7 × current weight/usual weight). The usual weight was defined as the stable weight 6 months before the illness in Kilograms. NRI \> 100 indicated that the patient is not malnourished, while 97.5-100 indicated mild malnourishment, 83.5-97.5 indicated moderate malnourishment and \<83.5 indicated severe malnourishment respectively. And BMI is defined as the weight in Kilograms divided by the square of height in Meters.

  3 years

Secondary Outcomes (1)

• Length of hospital stay and cost

  3 years

Eligibility Criteria

• Age: 35 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All the patient who underwent major GI surgery in NAMS Bir Hospital (a tertiary level hospital of Government of Nepal) between 2015 to 2017.

You may qualify if:

• All the patients who underwent major GI surgery, under general anesthesia, were included in the study. Major was defined as surgery involving \>2hrs and

You may not qualify if:

• Excluded were an emergency major operation, gallstone disease operations, patients with cough, fever, and chest infections respectively

Sponsors & Collaborators

• National Academy of Medical Sciences, Nepal: lead

Study Sites (1)

Department of Surgical Gastroenterology

Kathmandu, 44600, Nepal

Location

Related Publications (15)

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  PMID: 27769782 RESULT

• Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, Baptista G, Barazzoni R, Blaauw R, Coats A, Crivelli A, Evans DC, Gramlich L, Fuchs-Tarlovsky V, Keller H, Llido L, Malone A, Mogensen KM, Morley JE, Muscaritoli M, Nyulasi I, Pirlich M, Pisprasert V, de van der Schueren MAE, Siltharm S, Singer P, Tappenden K, Velasco N, Waitzberg D, Yamwong P, Yu J, Van Gossum A, Compher C; GLIM Core Leadership Committee; GLIM Working Group. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019 Feb;38(1):1-9. doi: 10.1016/j.clnu.2018.08.002. Epub 2018 Sep 3.

  PMID: 30181091 RESULT

• Pereira TG, da Silva Fink J, Silva FM. Thickness of the adductor pollicis muscle: Accuracy in predicting malnutrition and length of intensive care unit stay in critically ill surgical patients: Thickness of the adductor pollicis muscle in surgical critically patients. Clin Nutr ESPEN. 2018 Apr;24:165-169. doi: 10.1016/j.clnesp.2017.10.013. Epub 2018 Feb 15.

  PMID: 29576356 RESULT

• Jensen GL, Mirtallo J, Compher C, Dhaliwal R, Forbes A, Grijalba RF, Hardy G, Kondrup J, Labadarios D, Nyulasi I, Castillo Pineda JC, Waitzberg D; International Consensus Guideline Committee. Adult starvation and disease-related malnutrition: a proposal for etiology-based diagnosis in the clinical practice setting from the International Consensus Guideline Committee. JPEN J Parenter Enteral Nutr. 2010 Mar-Apr;34(2):156-9. doi: 10.1177/0148607110361910.

  PMID: 20375423 RESULT

• Pichard C, Kyle UG, Morabia A, Perrier A, Vermeulen B, Unger P. Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay. Am J Clin Nutr. 2004 Apr;79(4):613-8. doi: 10.1093/ajcn/79.4.613.

  PMID: 15051605 RESULT

• Yasunaga H, Horiguchi H, Matsuda S, Fushimi K, Hashimoto H, Ayanian JZ. Body mass index and outcomes following gastrointestinal cancer surgery in Japan. Br J Surg. 2013 Sep;100(10):1335-43. doi: 10.1002/bjs.9221.

  PMID: 23939845 RESULT

• Schiesser M, Kirchhoff P, Muller MK, Schafer M, Clavien PA. The correlation of nutrition risk index, nutrition risk score, and bioimpedance analysis with postoperative complications in patients undergoing gastrointestinal surgery. Surgery. 2009 May;145(5):519-26. doi: 10.1016/j.surg.2009.02.001. Epub 2009 Mar 27.

  PMID: 19375611 RESULT

• Pablo AM, Izaga MA, Alday LA. Assessment of nutritional status on hospital admission: nutritional scores. Eur J Clin Nutr. 2003 Jul;57(7):824-31. doi: 10.1038/sj.ejcn.1601616.

  PMID: 12821882 RESULT

• Buzby GP, Knox LS, Crosby LO, Eisenberg JM, Haakenson CM, McNeal GE, Page CP, Peterson OL, Reinhardt GF, Williford WO. Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients. Am J Clin Nutr. 1988 Feb;47(2 Suppl):366-81. doi: 10.1093/ajcn/47.2.366.

  PMID: 3124598 RESULT

• Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. Perioperative total parenteral nutrition in surgical patients. N Engl J Med. 1991 Aug 22;325(8):525-32. doi: 10.1056/NEJM199108223250801.

  PMID: 1906987 RESULT

• Sungurtekin H, Sungurtekin U, Hanci V, Erdem E. Comparison of two nutrition assessment techniques in hospitalized patients. Nutrition. 2004 May;20(5):428-32. doi: 10.1016/j.nut.2004.01.006.

  PMID: 15105029 RESULT

• Oh CA, Kim DH, Oh SJ, Choi MG, Noh JH, Sohn TS, Bae JM, Kim S. Nutritional risk index as a predictor of postoperative wound complications after gastrectomy. World J Gastroenterol. 2012 Feb 21;18(7):673-8. doi: 10.3748/wjg.v18.i7.673.

  PMID: 22363139 RESULT

• Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of relative weight and obesity. Int J Epidemiol. 2014 Jun;43(3):655-65. doi: 10.1093/ije/dyu058. Epub 2014 Apr 1.

  PMID: 24691951 RESULT

• WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004 Jan 10;363(9403):157-63. doi: 10.1016/S0140-6736(03)15268-3.

  PMID: 14726171 RESULT

• Kulig J, Sierzega M, Kolodziejczyk P, Dadan J, Drews M, Fraczek M, Jeziorski A, Krawczyk M, Starzynska T, Wallner G; Polish Gastric Cancer Study Group. Implications of overweight in gastric cancer: A multicenter study in a Western patient population. Eur J Surg Oncol. 2010 Oct;36(10):969-76. doi: 10.1016/j.ejso.2010.07.007. Epub 2010 Aug 21.

  PMID: 20727706 RESULT

Related Links

• WHO fact sheet

MeSH Terms

Conditions

Postoperative Complications

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Nabin Pokharel, MCh

  NAMS, Bir Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE ONLY
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor/ Senior Medical Officer

Study Record Dates

• First Submitted: July 27, 2019
• First Posted: July 31, 2019
• Study Start: July 1, 2015
• Primary Completion: May 1, 2017
• Study Completion: May 1, 2017
• Last Updated: September 19, 2019

Record last verified: 2019-08

Locations

NE (1)