Hostname: page-component-76fb5796d-vvkck Total loading time: 0 Render date: 2024-04-26T23:18:33.842Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of preoperative nutritional status on postoperative quality of recovery: a prospective observational study

Published online by Cambridge University Press:  05 May 2023

Yuki Kinugasa ,
Mitsuru Ida Open the ORCID record for Mitsuru Ida [Opens in a new window] ,
Shohei Nakatani ,
Kayo Uyama  and
Masahiko Kawaguchi
Yuki Kinugasa
Affiliation:
Department of Anaesthesiology, Nara Medical University, Nara 634-8522, Japan
Mitsuru Ida*
Affiliation:
Department of Anaesthesiology, Nara Medical University, Nara 634-8522, Japan
Shohei Nakatani
Affiliation:
Department of Anaesthesiology, Nara Medical University, Nara 634-8522, Japan Department of Anaesthesiology, Akashi Medical Centre, Akashi, Japan
Kayo Uyama
Affiliation:
Department of Anaesthesiology, Nara Medical University, Nara 634-8522, Japan
Masahiko Kawaguchi
Affiliation:
Department of Anaesthesiology, Nara Medical University, Nara 634-8522, Japan
*
*Corresponding author: Mitsuru Ida, email nwnh0131@yahoo.co.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Quality of Recovery-15 (QoR-15) has received attention as a postoperative patient-reported outcome measure. Preoperative nutritional status has negative effects on postoperative outcomes; however, these associations have not yet been investigated. We included inpatients aged ≥ 65 years who underwent elective abdominal cancer surgery under general anaesthesia between 1 June 2021 and 7 April 2022 at our hospital. Preoperative nutritional status was assessed using the Mini Nutritional Assessment Short-Form (MNA-SF), and patients with an MNA-SF score ≤ 11 were categorised into the poor nutritional group. The outcomes in this study were the QoR-15 scores at 2 d, 4 d and 7 d after surgery, which were compared between groups by unpaired t test. Multiple regression analysis was applied to assess the effects of poor preoperative nutritional status on the QoR-15 score on postoperative day 2 (POD 2). Of the 230 included patients, 33·9 % (78/230) were categorised into the poor nutritional status group. The mean QoR-15 value was significantly lower in the poor nutritional group than in the normal nutritional group at all postoperative time points (POD 2:117 v. 99, P = 0·002; POD 4:124 v. 113, P < 0·001; POD 7:133 v. 115, P < 0·001). Multiple analyses showed that poor preoperative nutritional status was associated with the QoR-15 score on POD 2 (adjusted partial regression coefficient, −7·8; 95 % CI −14·9, −0·72). We conclude that patients with a poor preoperative nutritional status were more likely to have a lower QoR-15 score after abdominal cancer surgery.

Keywords

Abdominal surgeryNutrition assessmentNutritional statusPatient-centred outcomePostoperative outcome
Type
Research Article
Information
British Journal of Nutrition , Volume 130 , Issue 11 , 14 December 2023 , pp. 1898 - 1903
Check for updates
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Nutrition Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kanemoto, M, Ida, M, Naito, Y, et al. (2022) The impact of preoperative nutrition status on abdominal surgery outcomes: a prospective cohort study. Nutr Clin Pract (Epublication ahead of print version 29 November 2022).Google ScholarPubMed
Wang, X, Naito, Y, Nakatani, H, et al. (2022) Prevalence of undernutrition in surgical patients and the effect on length of hospital stay. J Anesth 36, 89–95.CrossRefGoogle ScholarPubMed
Gn, YM, Abdullah, HR, Loke, W, et al. (2021) Prevalence and risk factors of preoperative malnutrition risk in older patients and its impact on surgical outcomes: a retrospective observational study. Can J Anaesth 68, 622–632.CrossRefGoogle ScholarPubMed
Kaiser, MJ, Bauer, JM, Ramsch, C, et al. (2009) Validation of the Mini Nutritional Assessment short-form (MNA®-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 13, 782–788.CrossRefGoogle ScholarPubMed
Kamperidis, N, Tesser, L, Wolfson, P, et al. (2020) Prevalence of malnutrition in medical and surgical gastrointestinal outpatients. Clin Nutr ESPEN 35, 188–193.CrossRefGoogle ScholarPubMed
Abola, RE, Bennett-Guerrero, E, Kent, ML, et al. (2018) Perioperative Quality Initiative (POQI) 2 Workgroup. American society for enhanced recovery and perioperative quality initiative joint consensus statement on patient-reported outcomes in an enhanced recovery pathway. Anesth Analg 126, 1874–1882.CrossRefGoogle Scholar
Wessels, E, Perrie, H, Scribante, J, et al. (2022) Quality of recovery in the perioperative setting: a narrative review. J Clin Anesth 78, 110685.CrossRefGoogle ScholarPubMed
Cohn, D, Castellon-Larios, K, Huffman, L, et al. (2016) A prospective, comparative study for the evaluation of postoperative pain and quality of recovery in patients undergoing robotic v. open hysterectomy for staging of endometrial cancer. J Minim Invasive Gynecol 23, 429–434.CrossRefGoogle Scholar
Buchanan, F, Myles, P & Cicuttini, F (2011) Effect of patient sex on general anaesthesia and recovery. Br J Anaesth 106, 832–839.CrossRefGoogle ScholarPubMed
Stark, PA, Myles, PS & Burke, JA (2013) Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15. Anesthesiology 118, 1332–1340.CrossRefGoogle ScholarPubMed
Nakatani, S, Ida, M, Tanaka, Y, et al. (2021) Translation and validation of the Japanese Version of the Quality of Recovery-15 Questionnaire. J Anesth 35, 426–433.CrossRefGoogle ScholarPubMed
Chen, S, Chen, T, Kishimoto, H, et al. (2020) Development of a fried frailty phenotype questionnaire for use in screening community-dwelling older adults. J Am Med Dir Assoc 21, 272–276.CrossRefGoogle Scholar
Myles, PS, Myles, DB, Galagher, W, et al. (2016) Minimal clinically important difference for three quality of recovery scales. Anesthesiology 125, 39–45.CrossRefGoogle ScholarPubMed
Myles, PS & Myles, DB (2021) An updated minimal clinically important difference for the QoR-15 scale. Anesthesiology 135, 934–935.CrossRefGoogle ScholarPubMed
Myles, PS (2020) More than just morbidity and mortality – quality of recovery and long-term functional recovery after surgery. Anaesth 75, e143–e150.CrossRefGoogle ScholarPubMed
Campfort, M, Cayla, C, Lasocki, S, et al. (2022) Early quality of recovery according to QoR-15 score is associated with one-month postoperative complications after elective surgery. J Clin Anesth 78, 110638.CrossRefGoogle ScholarPubMed
Mosquera, C, Koutlas, NJ, Edwards, KC, et al. (2016) Impact of malnutrition on gastrointestinal surgical patients. J Surg Res 205, 95–101.CrossRefGoogle ScholarPubMed
Pelavski, AD, De Miguel, M, Alcaraz Garcia-Tejedor, G, et al. (2017) Mortality, geriatric, and nongeriatric surgical risk factors among the eldest old: a prospective observational study. Anesth Analg 125, 1329–1336.CrossRefGoogle ScholarPubMed
Lee, LC & Tsai, AC (2012) Mini Nutritional Assessment (MNA) without body mass index (BMI) predicts functional disability in elderly Taiwanese. Arch Gerontol Geriatr 54, e405–e410.CrossRefGoogle ScholarPubMed
Tsai, HJ (2013) Nutrition risk, functional dependence, and co-morbidities affect depressive symptoms in Taiwanese aged 53 years and over: a population-based longitudinal study. J Psychosom Res 75, 173–177.CrossRefGoogle Scholar
Soysal, P, Veronese, N, Arik, F, et al. (2019) Mini Nutritional Assessment Scale-Short Form can be useful for frailty screening in older adults. Clin Interv Aging 14, 693–699.CrossRefGoogle ScholarPubMed
Li, CQ, Zhang, C, Yu, F, et al. (2022). Severe functional impairment increases the risk of major morbidity and mortality in older patients after digestive tract surgery: a retrospective cohort study. J Anesth 36, 464–475.CrossRefGoogle ScholarPubMed
Myles, P, Weitkamp, B, Jones, K, et al. (2000) Validity and reliability of a postoperative quality of recovery score: the QoR-40. Br J Anaesth 84, 11–15.CrossRefGoogle ScholarPubMed
Demumieux, F, Ludes, P, Diemunsch, P, et al. (2020) Validation of the translated Quality of Recovery-15 questionnaire in a French-speaking population. Br J Anaesth 124, 761–767.CrossRefGoogle Scholar
Wessels, E, Perrie, H, Scribante, J, et al. (2021) Quality of recovery following orthopedic surgery in patients at an academic hospital in South Africa. Anesth Analg 133, 507–514.CrossRefGoogle ScholarPubMed
Supplementary material: File

Kinugasa et al. supplementary material

Table S1

Download Kinugasa et al. supplementary material(File)
File 15.3 KB