Preoperative immunonutrition and postoperative outcomes in patients with cancer undergoing major abdominal surgery: retrospective cohort study.

Autor: Chona Chona M; Grupo de soporte nutricional. Clínica Universitaria Colombia, Grupo Keralty, Bogotá, Colombia., Lopez Basto LM; Grupo de soporte nutricional. Clínica Universitaria Colombia, Grupo Keralty, Bogotá, Colombia., Pinzón Ospina C; Grupo de soporte nutricional. Clínica Universitaria Colombia, Grupo Keralty, Bogotá, Colombia; Grupo de Investigación en Nutrición Clínica y Rehabilitación, Fundación Universitaria Sanitas, Clínicas Colsanitas, Grupo Keralty, Bogotá, Colombia., Pardo Coronado AC; Grupo de soporte nutricional. Clínica Universitaria Colombia, Grupo Keralty, Bogotá, Colombia., Guzmán Silva MP; Grupo de Investigación en Nutrición Clínica y Rehabilitación, Fundación Universitaria Sanitas, Clínicas Colsanitas, Grupo Keralty, Bogotá, Colombia., Marín M; Director médico. Megalabs, Miami, Estados Unidos., Vallejos A; Director médico. Megalabs SAS, Bogotá, Colombia., Castro Osmán GE; Director médico. Megalabs SAS, Bogotá, Colombia., Saavedra C; Departamento de infectología. Clínica Universitaria Colombia, Grupo Keralty, Bogotá, Colombia., Díaz Rojas J; Departamento de Farmacia. Faculta de Ciencias. Universidad Nacional de Colombia. Sede Bogotá., Medina-Parra J; Grupo de Investigación en Nutrición Clínica y Rehabilitación, Fundación Universitaria Sanitas, Clínicas Colsanitas, Grupo Keralty, Bogotá, Colombia; Vicepresidencia de innovación y desarrollo científico, Clínica Universitaria Colombia, Clínica Infantil Santa María del Lago, Clínica Reina Sofía Pediátrica y Mujer, Clínicas Colsanitas, Grupo Keralty, Bogotá, Colombia., Merchán-Chaverra RA; Grupo de Investigación en Nutrición Clínica y Rehabilitación, Fundación Universitaria Sanitas, Clínicas Colsanitas, Grupo Keralty, Bogotá, Colombia; Facultad de Medicina, Fundación Universitaria Sanitas, Bogotá, Colombia; Vicepresidencia de innovación y desarrollo científico, Clínica Universitaria Colombia, Clínica Infantil Santa María del Lago, Clínica Reina Sofía Pediátrica y Mujer, Clínicas Colsanitas, Grupo Keralty, Bogotá, Colombia. Electronic address: ricardomc9275@gmail.com.
Jazyk: angličtina
Zdroj: Clinical nutrition ESPEN [Clin Nutr ESPEN] 2024 Dec 14. Date of Electronic Publication: 2024 Dec 14.
DOI: 10.1016/j.clnesp.2024.12.011
Abstrakt: Background and Objectives: Surgical resection is a first-line treatment for patients with cancer, but preoperative malnutrition is a risk factor for postoperative complications. This study aimed to evaluate the association between preoperative administration of an immunonutrition regimen and postoperative clinical outcomes in patients with cancer undergoing major abdominal surgery.
Methods: The Surgical Prehabilitation Multimodal Oncology (SUPREMO) retrospective cohort study, conducted from January 2021 to December 2023, included patients with cancer undergoing major abdominal surgery. Patients were categorized based on whether they received a complete immunonutrition regimen or an incomplete or no regimen. Demographic and clinical data were extracted from electronic health records for descriptive analysis. Logistic regression was used to assess the impact of immunonutrition on the risk of infectious complications, with clinical and demographic variables as explanatory factors.
Results: A total of 620 patients were included, with 49% receiving a complete preoperative immunonutrition regimen. Bivariate analysis indicated that complete regimen administration was associated with lower intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and vasopressor support requirements (p = 0.005, p = 0.019, and p = 0.032, respectively). The logistic regression model showed a significant reduction in in-hospital infectious complications (odds ratio 0.54, 95% confidence interval 0.31-0.98; p = 0.044).
Conclusion: Administering a complete preoperative immunonutrition regimen may be associated with reduced infectious complications, ICU and IMV requirements, and vasopressor support use.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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