Malnutrition as a predictor of poor postoperative outcomes in gynecologic cancer patients

Anupama S Q Kathiresan, Kathleen Brookfield, Samer I. Schuman, Joseph A. Lucci

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Purpose Poor nutritional status has been associated with increased postoperative morbidity and mortality in surgical patients. The purpose of this study is to evaluate if decreased nutritional parameters correlate with increased postoperative complications regardless of other risk factors in the gynecologic cancer patient. Methods A retrospective chart review was performed among women who underwent surgical management for gynecologic malignancies from October 2006 to June 2008. Variables included age, race, medical comorbidities, cancer type/stage, preoperative albumin, absolute lymphocyte count (ALC), and body mass index (BMI), estimated blood loss (EBL), intraoperative blood transfusion (BT), intraoperative or postoperative complications, intensive care unit (ICU) admissions, hospital readmissions, reoperations, and cancer recurrence. Results Three hundred gynecologic oncology patients with preoperative nutritional parameters were included in the study. Decreased albumin was significantly associated with more postoperative complications (p <0.001), hospital readmissions (p = 0.01), reoperations (p = 0.03), ICU admissions (p <0.001), and cancer recurrence (p <0.001). Decreased ALC and BMI preoperatively was also significantly associated with higher incidence of cancer recurrence (p = 0.01, p = 0.01). Surgical cases involving increased EBL (p = 0.01, p <0.001) and more BT (p <0.001, p <0.001) had significantly more postoperative complications and more ICU admissions. Multivariable logistic regression found preoperative albumin to be an independent predictor of increased postoperative complications. Conclusions Decreased albumin is significantly associated with more postoperative complications, hospital readmissions, reoperations, ICU admissions, and cancer recurrence. This nutritional parameter is an important predictor of postoperative morbidity and mortality. Thus, it is important to assess nutritional status preoperatively and offer nutritional support or alternate treatment options if necessary.

Original languageEnglish (US)
Pages (from-to)445-451
Number of pages7
JournalArchives of Gynecology and Obstetrics
Volume284
Issue number2
DOIs
StatePublished - Aug 2011
Externally publishedYes

Fingerprint

Malnutrition
Patient Readmission
Intensive Care Units
Albumins
Reoperation
Neoplasms
Recurrence
Lymphocyte Count
Nutritional Status
Blood Transfusion
Body Mass Index
Morbidity
Nutritional Support
Mortality
Intraoperative Complications
Comorbidity
Logistic Models
Incidence

Keywords

  • Albumin
  • Gynecology oncology
  • Malnutrition
  • Postoperative complications

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Malnutrition as a predictor of poor postoperative outcomes in gynecologic cancer patients. / Kathiresan, Anupama S Q; Brookfield, Kathleen; Schuman, Samer I.; Lucci, Joseph A.

In: Archives of Gynecology and Obstetrics, Vol. 284, No. 2, 08.2011, p. 445-451.

Research output: Contribution to journalArticle

Kathiresan, Anupama S Q ; Brookfield, Kathleen ; Schuman, Samer I. ; Lucci, Joseph A. / Malnutrition as a predictor of poor postoperative outcomes in gynecologic cancer patients. In: Archives of Gynecology and Obstetrics. 2011 ; Vol. 284, No. 2. pp. 445-451.
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abstract = "Purpose Poor nutritional status has been associated with increased postoperative morbidity and mortality in surgical patients. The purpose of this study is to evaluate if decreased nutritional parameters correlate with increased postoperative complications regardless of other risk factors in the gynecologic cancer patient. Methods A retrospective chart review was performed among women who underwent surgical management for gynecologic malignancies from October 2006 to June 2008. Variables included age, race, medical comorbidities, cancer type/stage, preoperative albumin, absolute lymphocyte count (ALC), and body mass index (BMI), estimated blood loss (EBL), intraoperative blood transfusion (BT), intraoperative or postoperative complications, intensive care unit (ICU) admissions, hospital readmissions, reoperations, and cancer recurrence. Results Three hundred gynecologic oncology patients with preoperative nutritional parameters were included in the study. Decreased albumin was significantly associated with more postoperative complications (p <0.001), hospital readmissions (p = 0.01), reoperations (p = 0.03), ICU admissions (p <0.001), and cancer recurrence (p <0.001). Decreased ALC and BMI preoperatively was also significantly associated with higher incidence of cancer recurrence (p = 0.01, p = 0.01). Surgical cases involving increased EBL (p = 0.01, p <0.001) and more BT (p <0.001, p <0.001) had significantly more postoperative complications and more ICU admissions. Multivariable logistic regression found preoperative albumin to be an independent predictor of increased postoperative complications. Conclusions Decreased albumin is significantly associated with more postoperative complications, hospital readmissions, reoperations, ICU admissions, and cancer recurrence. This nutritional parameter is an important predictor of postoperative morbidity and mortality. Thus, it is important to assess nutritional status preoperatively and offer nutritional support or alternate treatment options if necessary.",
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N2 - Purpose Poor nutritional status has been associated with increased postoperative morbidity and mortality in surgical patients. The purpose of this study is to evaluate if decreased nutritional parameters correlate with increased postoperative complications regardless of other risk factors in the gynecologic cancer patient. Methods A retrospective chart review was performed among women who underwent surgical management for gynecologic malignancies from October 2006 to June 2008. Variables included age, race, medical comorbidities, cancer type/stage, preoperative albumin, absolute lymphocyte count (ALC), and body mass index (BMI), estimated blood loss (EBL), intraoperative blood transfusion (BT), intraoperative or postoperative complications, intensive care unit (ICU) admissions, hospital readmissions, reoperations, and cancer recurrence. Results Three hundred gynecologic oncology patients with preoperative nutritional parameters were included in the study. Decreased albumin was significantly associated with more postoperative complications (p <0.001), hospital readmissions (p = 0.01), reoperations (p = 0.03), ICU admissions (p <0.001), and cancer recurrence (p <0.001). Decreased ALC and BMI preoperatively was also significantly associated with higher incidence of cancer recurrence (p = 0.01, p = 0.01). Surgical cases involving increased EBL (p = 0.01, p <0.001) and more BT (p <0.001, p <0.001) had significantly more postoperative complications and more ICU admissions. Multivariable logistic regression found preoperative albumin to be an independent predictor of increased postoperative complications. Conclusions Decreased albumin is significantly associated with more postoperative complications, hospital readmissions, reoperations, ICU admissions, and cancer recurrence. This nutritional parameter is an important predictor of postoperative morbidity and mortality. Thus, it is important to assess nutritional status preoperatively and offer nutritional support or alternate treatment options if necessary.

AB - Purpose Poor nutritional status has been associated with increased postoperative morbidity and mortality in surgical patients. The purpose of this study is to evaluate if decreased nutritional parameters correlate with increased postoperative complications regardless of other risk factors in the gynecologic cancer patient. Methods A retrospective chart review was performed among women who underwent surgical management for gynecologic malignancies from October 2006 to June 2008. Variables included age, race, medical comorbidities, cancer type/stage, preoperative albumin, absolute lymphocyte count (ALC), and body mass index (BMI), estimated blood loss (EBL), intraoperative blood transfusion (BT), intraoperative or postoperative complications, intensive care unit (ICU) admissions, hospital readmissions, reoperations, and cancer recurrence. Results Three hundred gynecologic oncology patients with preoperative nutritional parameters were included in the study. Decreased albumin was significantly associated with more postoperative complications (p <0.001), hospital readmissions (p = 0.01), reoperations (p = 0.03), ICU admissions (p <0.001), and cancer recurrence (p <0.001). Decreased ALC and BMI preoperatively was also significantly associated with higher incidence of cancer recurrence (p = 0.01, p = 0.01). Surgical cases involving increased EBL (p = 0.01, p <0.001) and more BT (p <0.001, p <0.001) had significantly more postoperative complications and more ICU admissions. Multivariable logistic regression found preoperative albumin to be an independent predictor of increased postoperative complications. Conclusions Decreased albumin is significantly associated with more postoperative complications, hospital readmissions, reoperations, ICU admissions, and cancer recurrence. This nutritional parameter is an important predictor of postoperative morbidity and mortality. Thus, it is important to assess nutritional status preoperatively and offer nutritional support or alternate treatment options if necessary.

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