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Tytuł:
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Malnutrition associated with an increased risk of postoperative complications following hepatectomy in patients with hepatocellular carcinoma.
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Autorzy:
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Huang TH; Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan. Electronic address: .
Hsieh CC; Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan; Department of Nutrition, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
Kuo LM; Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
Chang CC; Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
Chen CH; Department of Surgery, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
Chi CC; Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, 33305, Taiwan.
Liu CH; Department of Nutrition, Chang Gung Memorial Hospital, Chiayi, 613, Taiwan.
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Źródło:
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HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2019 Sep; Vol. 21 (9), pp. 1150-1155. Date of Electronic Publication: 2019 Feb 11.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: 2016- : Oxford, UK : Elsevier
Original Publication: 1999-2001: Oxford, England : ISIS Medical Media
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MeSH Terms:
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Hepatectomy*
Carcinoma, Hepatocellular/*surgery
Liver Neoplasms/*surgery
Malnutrition/*complications
Postoperative Complications/*etiology
Aged ; Female ; Humans ; Male ; Middle Aged ; Nutrition Assessment ; Nutritional Status ; Risk Factors ; Taiwan
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Entry Date(s):
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Date Created: 20190216 Date Completed: 20200415 Latest Revision: 20200415
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Update Code:
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20240105
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DOI:
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10.1016/j.hpb.2019.01.003
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PMID:
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30765200
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Background: The aim of this study was to analyze the nutritional risk factors for postoperative complications following hepatic resection for hepatocellular carcinoma (HCC).
Methods: The preoperative nutritional status of patients with HCC who underwent hepatic resection was evaluated using the scored Patient-Generated Subjective Global Assessment (PG-SGA). The perioperative variables were compared between well-nourished and malnourished patients. Regression analysis was employed to identify the risk factors for postoperative complications.
Results: The overall operative mortality and morbidity of 287 patients who underwent resection for HCC were 1.7% and 44.3%, respectively. Upon admission, 96 (33.4%) study participants were malnourished, which was associated with a significantly higher PG-SGA score (P < 0.001), higher frequency of comorbidity (P < 0.001), more postoperative complications (P < 0.001) and a longer length of hospital stay (P < 0.001). In addition, major complications (Clavien-Dindo classification ≥ IIIa) occurred significantly more frequently in the malnourished group (P < 0.01). Age ≥70 years (risk ratio [RR] = 2.50, P = 0.008) and PG-SGA score ≥ 4 ([RR] = 9.85, P < 0.001) were significant risk factors for postoperative complications.
Conclusions: The PG-SGA score is an effective tool for predicting postoperative complications in patients with HCC following hepatic resection.
(Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
