Korean J Clin Oncol.  2017 Dec;13(2):118-125. 10.14216/kjco.17018.

Impact of nutritional screening index on perioperative morbidity after colorectal cancer surgery as a independent predictive factor

• Kang YH
• Park JW
• Ryoo SB
• Jeong SY
• Park KJ

• KMID: 2405652
• DOI: http://doi.org/10.14216/kjco.17018

Abstract

PURPOSE
Nutrition status is an important factor for perioperative morbidity in cancer surgery. The aim of this study was to evaluate the impact of the malnutrition risk, determined by Seoul National University Hospital-nutrition screening index (SNUH-NSI), on operative morbidity after colorectal surgery for cancer.
METHODS
This study enrolled 2,462 patients who had undergone colectomy for initially diagnosed colorectal cancer at Seoul National University Hospital from January 2011 to December 2014. We collected general patient information, SNUH-NSI and prognostic nutritional index (PNI) at administration and related parameters (serum albumin, cholesterol, total lymphocyte counts, hemoglobin and body mass index), operative method, hospital stay and operative morbidity.
RESULTS
Patients' mean age was 62.12 years, and 423 patients (17.18%) were rated as severe malnutrition risk. Patients with high risk of malnutrition by SNUH-NSI or PNI, men, higher American Society of Anesthesiologists (ASA) class, palliative operation, and higher stage showed higher operative morbidity (P < 0.05). On multivariate analysis, significant independent risk factors for operative morbidity were severe malnutrition by SNUH-NSI (odds ratio [OR], 1.868; 95% confidence interval [CI], 1.429-2.442; P < 0.001) or PNI (OR, 1.596; 95% CI, 1.258-2.025; P < 0.001), men (OR, 1.483; 95% CI, 1.174-1.876; P=0.001), or high ASA class (OR, 1.782; 95% CI, 1.136-2.795; P=0.012).
CONCLUSION
Overall nutritional status, rather than single data, shows significant association with postoperative morbidity in patients who underwent colectomy. Especially severe malnutrition determined by SNUH-NSI, is an independent risk factor for perioperative morbidity. Nutritional support to severely malnourished patient by SNUH-NSI is expected to be effective in preventing complications after colectomy of colorectal carcinoma patients.

Keyword

Colorectal cancer; Colectomy; Malnutrition; Screening; Morbidity

MeSH Terms

Cholesterol
Colectomy
Colorectal Neoplasms*
Colorectal Surgery
Humans
Length of Stay
Lymphocyte Count
Male
Malnutrition
Mass Screening*
Methods
Multivariate Analysis
Nutrition Assessment
Nutritional Status
Nutritional Support
Risk Factors
Seoul
Cholesterol