| Autor: |
Aya Riad, Stephen R Knight, Dhruv Ghosh, Pamela A Kingsley, Marie Carmela Lapitan, Marie Dione Parreno-Sacdalan, Sudha Sundar, Ahmad Uzair Qureshi, Apple P Valparaiso, Riinu Pius, Catherine A Shaw, Thomas M Drake, Lisa Norman, Adesoji O Ademuyiwa, Adewale O Adisa, Maria Lorena Aguilera, Sara W Al-Saqqa, Ibrahim Al-Slaibi, Aneel Bhangu, Bruce M Biccard, Peter Brocklehurst, Sorrel Burden, Kathryn Chu, Ainhoa Costas-Chavarri, Anna J Dare, Muhammed Elhadi, Cameron J Fairfield, J Edward Fitzgerald, James Glasbey, Mark I. van Berge Henegouwen, J.C. Allen Ingabire, T Peter Kingham, Ismaïl Lawani, Bettina Lieske, Richard Lilford, Laura Magill, Mayaba Maimbo, Janet Martin, Sonia Mathai, Kenneth A McLean, Rachel Moore, Dion Morton, Dmitri Nepogodiev, John Norrie, Faustin Ntirenganya, Francesco Pata, Thomas Pinkney, Rajkumar Kottayasamy Seenivasagam, Antonio Ramos-De la Medina, Tracey E Roberts, Hosni Khairy Salem, Joana Simões, Richard JE Skipworth, Richard T Spence, Neil Smart, Stephen Tabiri, Evropi Theodoratou, Hannah Thomas, Thomas G Weiser, Malcolm West, John Whitaker, Edwin Yenli, Ewen M Harrison |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
|
| Zdroj: |
The Lancet Global Health, Vol 11, Iss 3, Pp e341-e349 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
2214-109X |
| DOI: |
10.1016/S2214-109X(22)00550-2 |
| Popis: |
Summary: Background: Malnutrition represents a key priority for global health policy, yet the impact of nutritional state on cancer surgery worldwide remains poorly described. We aimed to analyse the effect of malnutrition on early postoperative outcomes following elective surgery for colorectal or gastric cancer. Methods: We did an international, multicentre, prospective cohort study of patients undergoing elective surgery for colorectal or gastric cancer between April 1, 2018, and Jan 31, 2019. Patients were excluded if the primary pathology was benign, they presented with cancer recurrence, or if they underwent emergency surgery (within 72 h of hospital admission). Malnutrition was defined with the Global Leadership Initiative on Malnutrition criteria. The primary outcome was death or a major complication within 30 days of surgery. Multilevel logistic regression and a three-way mediation analysis were done to establish the relationship between country income group, nutritional status, and 30-day postoperative outcomes. Findings: This study included 5709 patients (4593 with colorectal cancer and 1116 with gastric cancer) from 381 hospitals in 75 countries. The mean age was 64·8 years (SD 13·5) and 2432 (42·6%) patients were female . Severe malnutrition was present in 1899 (33·3%) of 5709 patients, with a disproportionate burden in upper-middle-income countries (504 [44·4%] of 1135) and low-income and lower-middle-income countries (601 [62·5%] of 962). After adjustment for patient and hospital risk factors, severe malnutrition was associated with an increased risk of 30-day mortality across all country income groups (high income: adjusted odds ratio [aOR] 1·96 [95% CI 1·14–3·37], p=0·015; upper-middle income: 3·05 [1·45–6·42], p=0·003; low income and lower-middle income: 11·57 [5·87–22·80], p |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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