The Effect of Nutritional Status on Morbidity after Elective Surgery for Benign Gastrointestinal Disease

Abstract

The effect of nutritional status on the morbidity and mortality of major gastrointestinal surgery for benign disease was studied in 32 patients. Malnutrition was defined as a serum albumin <3.5 g/dl and a recent weight loss >10%, in addition to any two of the following: weight for height, mid-arm circumference or triceps skin-fold thickness <10th percentile. The morbidity and mortality in the 17 malnourished patients was 59% and 29%, respectively, compared with 20% and 7% in 15 well-nourished patients matched for age and operative procedure (p < 0.05). After operation, the mean duration of inadequate oral nutritional intake period (IONIP, defined as a caloric intake >60% requirement) was 11.9 days ± 2.9 (SEM) in well-nourished patients compared with 30.5 days ± 3.7 in the malnourished group. The longer IONIP in malnourished patients was a consequence of the higher morbidity in this group, thus warranting the consideration of supportive (postoperative) parenteral nutrition in malnourished patients who undergo major gastrointestinal surgery for benign disease. (Journal of Parenteral and Enteral Nutrition 11: 140-143, 1987)