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Clinical nutrition

Nutritional risk screening score is an independent predictive factor of anastomotic leakage after rectal cancer surgery

European Journal of Clinical Nutrition volume 72, pages 489–495 (2018)Cite this article

Subjects

Abstract

Background/objectives

Nutritional risk screening (NRS) score has been reported as a predictor of postoperative outcomes in patients undergoing abdominal surgery, although the correlation between NRS and anastomotic leakage (AL) after rectal cancer surgery is uncertain. This study aimed to evaluate the association between NRS score and AL following rectal cancer surgery.

Subject/methods

We retrospectively reviewed data of rectal cancer patients from a tertiary referral center in South Korea, and included 1063 patients with primary rectal cancer who underwent sphincter-preserving surgery between January 2011 and December 2015. We utilized the Chonnam National University Hwasun Hospital-Nutritional Risk Screening Tool (CNUHH-NRST), which was developed and cross-validated on the basis of the NRS 2002 and MST, as a screening tool of nutritional risk. Patients with NRS scores ≥4 were compared with those with NRS scores <4, and the risk factors for AL were analyzed.

Results

One-hundred-nineteen (11.2%) patients had high nutritional risk (NRS score ≥4). The patients with a nutritional risk had more advanced tumor stages than those without nutritional risk. AL occurred in 69 (6.5%) patients. The multivariate logistic regression analysis showed high American Society of Anesthesiologists score (odds ratio (OR) = 2.435, 95% confidence interval (CI) = 1.085–5.469), long operative time (OR = 1.975, 95% CI = 1.177–3.313), and high NRS score (OR = 2.044, 95% CI = 1.085–3.851) as independent risk factors of AL.

Conclusions

The NRS score was an independent predictive factor of AL after rectal cancer surgery. Patients with nutritional risks who require rectal cancer surgery should be carefully managed.

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Authors and Affiliations

  1. Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, Hwasun, Korea

    Soo Young Lee, Mi Ran Jung, Chang Hyun Kim, Young Jin Kim & Hyeong Rok Kim

  2. Nutritional Support Team, Chonnam National University Hwasun Hospital, Hwasun, Korea

    Soo Young Lee & Mi Ran Jung

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Correspondence to Hyeong Rok Kim.

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Lee, S.Y., Jung, M.R., Kim, C.H. et al. Nutritional risk screening score is an independent predictive factor of anastomotic leakage after rectal cancer surgery. Eur J Clin Nutr 72, 489–495 (2018). https://doi.org/10.1038/s41430-018-0112-3

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