Malnutrition after vascular surgery: are patients with chronic renal failure at increased risk?
| Autor: | Akihito Muto, Tormod S. Westvik, Sanjeev Pradhan, Hilde H. Westvik, Richard J. Gusberg, Reuben Rutland, Lauren K. Krause, Jose O Leite, Fabio A. Kudo, Alan Dardik, Stephen P. Maloney, Charles Cha |
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| Rok vydání: | 2006 |
| Předmět: |
Parenteral Nutrition
medicine.medical_specialty medicine.medical_treatment Nutritional Status Pilot Projects Comorbidity Carotid endarterectomy Risk Factors medicine Humans Vascular Diseases Risk factor Veterans Affairs Retrospective Studies Endarterectomy Carotid business.industry Malnutrition General Medicine Odds ratio Perioperative Vascular surgery medicine.disease Abdominal aortic aneurysm Surgery Nutrition Assessment Treatment Outcome Multivariate Analysis Kidney Failure Chronic business Vascular Surgical Procedures Diabetic Angiopathies Aortic Aneurysm Abdominal |
| Zdroj: | The American Journal of Surgery. 192:e22-e27 |
| ISSN: | 0002-9610 |
| DOI: | 10.1016/j.amjsurg.2006.07.004 |
| Popis: | Background The deleterious effects of perioperative malnutrition on recovery after general surgery are established. Since the effects of perioperative malnutrition on recovery after vascular surgery are not known, we examined the effects of nutritional status, and risk factors predictive of malnutrition, on outcome after vascular surgery. Methods The records of all open index vascular cases (abdominal aortic aneurysm [AAA] repair, carotid endarterectomy [CEA], lower extremity bypass) performed at the Veterans Affairs (VA) Connecticut between July 2004 and June 2005 were reviewed. The primary outcome was mortality; secondary outcomes included infection and nutritional risk index (NRI) scores. Results Sixty-eight open vascular cases were performed during the study period. Nutritional depletion developed in 55% of patients and was more likely in patients undergoing AAA (85%) or bypass (77%) than CEA (30%; P = .0005). Patients who developed malnutrition had similar mortality as patients who did not develop postoperative malnutrition (6.1% vs. 3.7%; P = .68); however, malnourished patients had higher rates of postoperative infection (24.2% vs. 3.7%; P = .03). Chronic renal failure was the only patient-associated risk factor predictive of postoperative nutritional depletion (odds ratio 5.9, confidence interval 1.0 to 33.6; P = .04). Conclusions Patients undergoing major open vascular surgery have high rates of postoperative malnutrition, with patients undergoing AAA repair having the highest rates of postoperative malnutrition and infection. Patients with chronic renal failure undergoing vascular surgery are associated with increased risk for postoperative malnutrition and may be a group to target for perioperative risk factor modification and nutritional supplementation. |
| Databáze: | OpenAIRE |
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