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Prevalence of malnutrition and nutritional assessment in abdominal-surgical patients; a prospective cross-sectional study.

OBJECTIVE
Nutritional intervention is important in abdominal-surgical patients. The primary objective was to determine the prevalence of malnutrition in abdominal-surgical patients. The secondary objectives were to determine the rate of nutritional assessment and the association of malnutrition to postoperative complications.


MATERIAL AND METHOD
106 elective abdominal-surgical patients at Thammasat hospital from September 2008 to February 2010 were assessed preoperatively by independent research assistant using ESPEN criteria for preoperative nutritional support as diagnostic criteria. The rate of nutritional assessment that had been done to these 106 patients by their responsible physicians was also determined using medical records and patients' interview by research assistant. Severe malnutritional patients according to ESPEN criteria that were not been assessed preoperatively by their responsible physicians about nutritional status were compared between benign and malignant group. The association of malnutrition to postoperative complications was also analyzed with adjusting for other confounding factors.


RESULTS
29 patients (27%) of 106 abdominal-surgical patients had malnutrition. The prevalence of malnutrition was significant higher inpatient with malignancy (18 from 31; 58%) than inpatient with benign diseases (11 from 75; 15%) with p-value less than 0.001. The rate of nutritional assessment by their responsible physicians (Benign 14 from 75; 19% vs. Malignant 24 from 31; 77%; p < 0.001) and severe malnutrition patients that had not been assessed by their responsible physicians (Benign 9 from 11; 82% vs. Malignant 2 from 18; 11%; p < 0.001) were significantly different. After adjusting for other confounding factors, malnutrition was significantly associated with postoperative complications with odds ratio of 3 and 95% CI of 1.1, and 8.4.


CONCLUSION
Malnutrition is common in abdominal-surgical patients. Routine preoperative nutritional assessment in this type of patients is recommended.