Your browser doesn't support javascript.
loading
Validation of the perioperative nutrition screen for prediction of postoperative outcomes.
Williams, David Ga; Aronson, Solomon; Murray, Sutton; Fuller, Matt; Villalta, Elizabeth; Haines, Krista L; Wischmeyer, Paul E.
Afiliación
  • Williams DG; Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
  • Aronson S; Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
  • Murray S; Population Health, Duke University School of Medicine, Durham, North Carolina, USA.
  • Fuller M; Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
  • Villalta E; Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
  • Haines KL; Duke University Health System, Durham, North Carolina, USA.
  • Wischmeyer PE; Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
JPEN J Parenter Enteral Nutr ; 46(6): 1307-1315, 2022 08.
Article en En | MEDLINE | ID: mdl-34850403
BACKGROUND: Preoperative nutrition risk is often underrecognized and undertreated. The perioperative nutrition screen (PONS) was recently introduced as an efficient tool to rapidly screen for preoperative nutrition risk. The relationship between identification of "nutrition risk" via PONS and adverse postoperative outcomes remains undescribed. METHODS: Preoperative nutrition risk was assessed via PONS from 01/01/2019 to 09/30/2020. Key clinical outcomes were compared with individual and composite PONS components. RESULTS: A total of 3151 patients with PONS evaluations were analyzed. Multivariate regression adjusted for key covariates demonstrated positive responses for specific PONS questions was associated with adverse clinical outcomes as follows. (1) Unplanned weight loss (>10% in 6-months preoperatively) associated with a 22.4% increased length of stay (LOS) (P < 0.0001) and increased 30-day readmission rate (odds ratio [OR], 2.44, 95% CI, 1.73-3.44, P < 0.001). (2) History of <50% of previous oral intake in past week associated with a 25% increased LOS (P < 0.001). (3) Preoperative serum albumin level <3.0 g/L associated with a 29.9% increased LOS (P < 0.001) and increased 30-day readmission rate (OR, 2.66, 95% CI, 1.63-4.35, P < 0.001). (4) Low body mass index was not associated with increased LOS by adjusted analysis although was predictive by univariate analysis. CONCLUSIONS: The PONS and its individual components appear to predict risk of adverse postoperative outcomes, even independent of a validated malnutrition diagnosis. Further studies are needed to assess the impact of specific preoperative nutrition interventions on adverse outcomes predicted by PONS when delivered to patients identified via PONS screen.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Desnutrición Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Humans Idioma: En Revista: JPEN J Parenter Enteral Nutr Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Desnutrición Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Humans Idioma: En Revista: JPEN J Parenter Enteral Nutr Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos