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Martínez-Escribano C, Arteaga Moreno F, Pérez-López M, Cunha-Pérez C, Belenguer-Varea Á, Cuesta Peredo D, Blanco González FJ, Tarazona-Santabalbina FJ. Malnutrition and Increased Risk of Adverse Outcomes in Elderly Patients Undergoing Elective Colorectal Cancer Surgery: A Case-Control Study Nested in a Cohort. Nutrients 2022; 14:nu14010207. [PMID: 35011082 PMCID: PMC8746820 DOI: 10.3390/nu14010207] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 12/22/2021] [Accepted: 12/27/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Malnutrition increases worse outcomes during hospital admission for elective colorectal cancer (CRC) surgery in older adults. Methods: This work was designed an observational, monocentric, case-control study nested in a cohort of patients undergoing elective surgery for CRC disease at the Hospital Universitario de la Ribera (HULR) (Alzira, Valencia, Spain) between 2011 and 2019. The study considered patients with a CONUT score in the range of moderate to severe malnutrition (>4 points), with control patients with normal nutritional situations or mild malnutrition. Results: Moderate-to-severe malnutrition cases presented a greater length of stay (LOS), a higher incidence of adverse events (both medical and surgical complications), a higher incidence of surgical-wound infection, a greater need for blood transfusion, and a greater amount of transfused packed red blood cells. During hospitalization, the percentage of patients without nutritional risk decreased from 46 to 9%, and an increase in mild, moderate, and severe risk was observed. Patients with severe nutritional risk at hospital admission had significantly increased mortality at 365 days after discharge (HR: 2.96 (95% CI 1.14–7.70, p = 0.002)). After adjusting for sex, age, and Charlson index score, patients with severe nutritional risk at admission maintained a higher mortality risk (HR: 3.08 (95% CI 1.10–8.63, p = 0.032)). Conclusion: Malnutrition prevalence is high in older adults undergoing CRC elective surgery. Furthermore, this prevalence increases during hospital admission. Malnutrition is linked to worse outcomes, such as LOS, surgical and clinical complications, and mortality. For this reason, nutritional interventions are very important in the perioperative period
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Affiliation(s)
- Cristina Martínez-Escribano
- Anesthesiology and Resuscitation, Hospital Universitario de la Ribera, 46600 Valencia, Spain;
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
| | - Francisco Arteaga Moreno
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
| | - Marcos Pérez-López
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
| | - Cristina Cunha-Pérez
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
| | - Ángel Belenguer-Varea
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | - David Cuesta Peredo
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
- Quality Management, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | | | - Francisco J. Tarazona-Santabalbina
- School of Doctorate, Catholic University of Valencia, San Vicente Martir, 46600 Valencia, Spain; (F.A.M.); (M.P.-L.); (C.C.-P.); (Á.B.-V.); (D.C.P.)
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), 28029 Madrid, Spain
- Correspondence:
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