Prevalence of Malnutrition and Nutritional Assessment in Abdominal-Surgical Patients; A Prospective Cross-Sectional Study
Boonying Siribumrungwong MD*, Baiboon Srithamma BNS**, Kittichai Kuntonpreeda MD*, Prakitpunthu Tomtitchong MD, PhD*, Veeraya Paochareun MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Thammasat University Rangsit Campus, Pathumthani, Thailand ** Department of Surgery, Thammasat Hospital, Pathumthani, Thailand
Objective : Nutritional intervention is important in abdominal-surgical patients. The primary objective was to determine the
prevalence of malnutrition in abdominal-surgical patients. The secondary objectives were to determine the rate of nutritional
assessment and the association of malnutrition to postoperative complications.
Material and Method: 106 elective abdominal-surgical patients at Thammasat hospital from September 2008 to February
2010 were assessed preoperatively by independent research assistant using ESPEN criteria for preoperative nutritional
support as diagnostic criteria. The rate of nutritional assessment that had been done to these 106 patients by their responsible
physicians was also determined using medical records and patients’ interview by research assistant. Severe malnutritional
patients according to ESPEN criteria that were not been assessed preoperatively by their responsible physicians about
nutritional status were compared between benign and malignant group. The association of malnutrition to postoperative
complications was also analyzed with adjusting for other confounding factors.
Results : 29 patients (27%) of 106 abdominal-surgical patients had malnutrition. The prevalence of malnutrition was
significant higher in patient with malignancy (18 from 31; 58%) than in patient with benign diseases (11 from 75; 15%) with
p-value less than 0.001. The rate of nutritional assessment by their responsible physicians (Benign 14 from 75; 19% vs.
Malignant 24 from 31; 77%; p < 0.001) and severe malnutrition patients that had not been assessed by their responsible
physicians (Benign 9 from 11; 82% vs. Malignant 2 from 18; 11%; p < 0.001) were significantly different. After adjusting for
other confounding factors, malnutrition was significantly associated with postoperative complications with odds ratio of 3
and 95% CI of 1.1, and 8.4.
Conclusion : Malnutrition is common in abdominal-surgical patients. Routine preoperative nutritional assessment in this
type of patients is recommended.
Keywords : Malnutrition, Preoperative, ESPEN, Surgery, Abdominal, Nutritional Assessment
