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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2015

01-12-2015 | Gastrointestinal Oncology

Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections

Authors: Yasunari Fukuda, MD, Kazuyoshi Yamamoto, MD, PhD, Motohiro Hirao, MD, PhD, Kazuhiro Nishikawa, MD, PhD, Sakae Maeda, MD, PhD, Naotsugu Haraguchi, MD, PhD, Masakazu Miyake, MD, PhD, Naoki Hama, MD, PhD, Atsushi Miyamoto, MD, PhD, Masataka Ikeda, MD, PhD, Shoji Nakamori, MD, PhD, Mitsugu Sekimoto, MD, PhD, Kazumasa Fujitani, MD, PhD, Toshimasa Tsujinaka, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2015

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Abstract

Background

Malnutrition is an independent risk factor for postoperative mortality and morbidity in major gastrointestinal surgery. The aim of this study was to investigate the prevalence of malnutrition and identify the optimal preoperative nutritional support for preventing postoperative surgical site infections (SSIs) in malnourished gastric cancer patients undergoing gastrectomy.

Methods

We analyzed 800 patients with gastric cancer who underwent gastrectomy. Nutritional risk factors included weight loss >10 % within 6 months, body mass index <18.5 kg/m2, Subjective Global Assessment Grade C, and serum albumin <3.0 g/dl. Adequate energy intake was defined as receiving ≥25 kcal/kg ideal body weight per day. Optimal nutritional support was examined in terms of both duration and calorie intake.

Results

Overall, 152 patients (19.0 %) were classified as malnourished. The incidence of SSIs was significantly higher in malnourished patients than in well-nourished patients (35.5 vs. 14.0 %; p < 0.0001). The incidence of SSIs in malnourished patients was significantly lower in the well-supported group receiving adequate energy support for at least 10 days than in the poorly-supported group, which received inadequate or no energy support or adequate energy support for <10 days (17.0 vs. 45.4 %; p = 0.0006). In multivariate analysis, well-managed nutritional support was identified as an independent factor associated with fewer SSIs (odds ratio 0.14; 95 % confidence interval 0.05–0.37; p = 0.0002).

Conclusions

Malnutrition, a risk factor for SSI, was prevalent in gastric cancer patients preoperatively. Well-managed preoperative nutritional support decreased the incidence of postoperative SSIs in malnourished patients.
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Metadata
Title
Prevalence of Malnutrition Among Gastric Cancer Patients Undergoing Gastrectomy and Optimal Preoperative Nutritional Support for Preventing Surgical Site Infections
Authors
Yasunari Fukuda, MD
Kazuyoshi Yamamoto, MD, PhD
Motohiro Hirao, MD, PhD
Kazuhiro Nishikawa, MD, PhD
Sakae Maeda, MD, PhD
Naotsugu Haraguchi, MD, PhD
Masakazu Miyake, MD, PhD
Naoki Hama, MD, PhD
Atsushi Miyamoto, MD, PhD
Masataka Ikeda, MD, PhD
Shoji Nakamori, MD, PhD
Mitsugu Sekimoto, MD, PhD
Kazumasa Fujitani, MD, PhD
Toshimasa Tsujinaka, MD, PhD
Publication date
01-12-2015
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2015
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4820-9

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