Annals of Clinical Nutrition and Metabolism

Original Articles

Nutritional Status of Patients with Hepatobiliary-Pancreatic Surgical Disease: Sang Soo Eom, Yong Chan Shin, Chang-Sup Lim, In Woong Han, Woohyun Jung, Yoonhyeong Byun, Dong Wook Choi, Jin Seok Heo, Hongbeom Kim; Surg Metab Nutr 2020;11(2):46-52. Published online December 30, 2020; DOI: https://doi.org/10.18858/smn.2020.11.2.46

Abstract PDF ePub: Purpose: This study examined the nutritional status of patients with hepatobiliary-pancreatic diseases before surgery to establish basic reference data.
Materials and Methods: This study evaluated retrospectively 2,322 patients admitted for hepatobiliary-pancreatic surgery between 2014 and 2016 at four Korean medical institutions using the body mass index (BMI) score. The prognostic nutrition index (PNI) was calculated in patients diagnosed with malignant diseases.
Results: The mean BMI was 24.0 kg/m² (range, 13.2~39.1 kg/m²). The patients were classified as low BMI (<21.5 kg/ m², below 25 percentile), intermediate BMI (21.5~25.5 kg/m²), and high BMI (>25.5 kg/m², above 75 percentile). There were significant differences in the age, sex distribution, ASA classification, type of hospitalization, biliary drainage, organ, and pathology diagnosis between the pairs among the low, intermediate, and high BMI groups. Among the three BMI groups, the complication rate of the low BMI group was highest (34.4% vs. 29.7% vs. 25.8% P=0.005). The median lengths of hospital stay in the low, intermediate, and high BMI groups were 9, 9, and 7 days, respectively (P<0.001). Multivariate analysis revealed the risk factors of the low BMI group to be a higher ASA classification, biliary drainage, pancreatic disease, and malignant disease. The group with PNI<45 had significantly longer hospital stays than the group with PNI≥45 (P<0.001).
Conclusion: Patients with a low BMI had a higher ASA classification, preoperative biliary drainage, pancreatic disease, and malignant disease. The low PNI group had significantly longer hospital stays than the high PNI group. Screening of the preoperative nutritional status is necessary for assessing the risk of malnutrition and its treatment.

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Recovery Pattern of the Nutritional Status after Surgical Treatment for Pancreatic Head Disease: Compared with Malignancy and Non-malignancy: Eunjung Kim, Youngmin Han, Hongbeom Kim, Wooil Kwon, Sun-Whe Kim, Jin-Young Jang; Surg Metab Nutr 2018;9(2):51-58. Published online December 30, 2018; DOI: https://doi.org/10.18858/smn.2018.9.2.51

Purpose:

Malnutrition affects the clinical outcomes of pancreatic disease. On the other hand, the changes in the nutritional status stratified by malignant and non-malignant diseases after surgery still need to be determined. The aim was to confirm the changing nutritional status and clinical outcomes after a pancreatoduodenectomy according to malignant and non-malignant disease.

Materials and Methods:

Data were collected prospectively from 157 patients between 2009 and 2015. The nutritional status was classified as well-nourished, at-risk of malnutrition, and malnourished by a Mini Nutrition Assessment. The clinical outcomes were assessed using the postoperative complication, hospital stay, biochemical nutritional markers, and quality-of-life (QOL).

Results:

Preoperatively, the proportion of malnourished status in the malignant disease group (group B) were 66.7% and 33.3% in the non-malignancy group (group A). The malnutrition rate in group B was higher than that in group A at 3, 6, and 12 months after surgery (58.1% vs. 41.9%, 90.0% vs. 10.0, 77.8% vs. 22.2%, respectively). The preoperative QOL was significantly lower in group B than in group A (P<.001); however, the QOL was comparable between the two groups after surgery. The body mass index was unrecovered after surgery in all groups.

Conclusion:

Patients with malignant pancreatic disease are more likely to suffer from a poor nutritional status than those with non-malignant pancreatic disease. One year after the pancreatoduodenctomy, the at-risk of malnutrition and malnourished rate were found to be over 70% in all patients. Therefore, more efforts will be needed to improve the nutritional status in pancreatic head disease.

Citations

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Factors Affecting Nutritional Index and Length of Stay in Pancreatic Cancer in the Older Adults
So Young Jun, Mo Na Choi, Joon Seong Park, Hyang Kyu Lee
Asian Oncology Nursing.2023; 23(3): 91. CrossRef

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