Preoperative Nutritional Assessment for Predicting Complications Risk in Patients Undergoing Abdominal Surgery

Predictive Value of Various Nutritional Screening and Assesment Tools and a Surgery Scoring System (POSSUM Score) for Predicting Postoperative Complications in Patients Scheduled for Abdominal Surgery

Predictive Value of Various Nutritional Screening and Assesment Tools and a Surgery Scoring System (POSSUM Score) for Predicting Postoperative Complications in Patients Scheduled for Abdominal Surgery.

Study Overview

• Status: Completed
• Conditions: Abdominal Surgery

Detailed Description

Preoperative malnutrition in surgical patients is an established risk factor of peri-operative morbidity and mortality, post-operative complications, infections and increased length of hospital stay. The reported prevalence of malnutrition in gastrointestinal (GI) and major abdominal surgery patients ranges from 30% to 50%. For these reasons it is important to recognize malnourished patients before surgery in order to provide the most appropriate preoperative nutritional therapy which will in turn improve nutritional status and reduce postoperative complications and length of hospital stay.

The aim of the present study was to compare the prognostic power of different screening tools for post - op complications. This was a prospective observational cohort study, performed in patients scheduled for an abdominal operation in the Second Department of Surgery, Evangelismos General Hospital in Athens, Greece. All patients were screened at admission and before operation. Data were collected in a special form by the dietician and the surgeon, with the use of screening tools and the local Electronic Medical Record System called "Emrora". Patients were followed up after surgery until discharge by the surgeon who recorded any complication or case of death in a new form.

• Study Type: Observational
• Enrollment (Actual): 450

Contacts and Locations

Study Locations

• Greece
  • Kolonaki
    • Athens, Kolonaki, Greece, 10676
      • Department of Nutrition and Dietetics, Evaggelismos Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients aged at least 18 years who presented with diseases of the digestive tract (oesophageal, gastric or intestinal), or with other abdominal diseases requiring elective surgery.

Description

Inclusion Criteria:

• 18 years at least
• Diseases of the digestive tract (oesophageal, gastric or intestinal), or other abdominal diseases requiring elective surgery,

Exclusion Criteria:

• Age < 18
• Pregnancy
• Major coagulopathy
• Permanent pacemaker
• Specific preoperative nutritional support before admission to hospital
• Unable to give consent

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Postoperative clinical complications.	Number of respiratory, cardiovascular, renal, neurological, infectious and surgical after surgery. Complication will be defined by the Clavien-Dindo classification and our primary outcome will be long-term complications higher than grade III.	3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Length of stay in hospital	Length of stay	3 months
All-cause mortality	All-cause mortality is assessed during in-hospital stay and 90 days after the date of surgery	3 months
Readmission	Readmission to the center within 180 days of the original procedure.	6 months
Accuracy of the POSSUM Scoring Systems to predict clinical complications and mortality.	Area Under the Receiver Operating Curve (ROC) as a Measure of the Accuracy of the P-POSSUM Scoring Systems to Predict clinical complications and mortality.	1 month

Collaborators and Investigators

• Sponsor: Evangelismos Hospital
• Investigators: Study Director: George Stylianides, MD, PhD, 2nd Department of Surgery

Publications and helpful links

Helpful Links

• The Efficacy of Nutritional Screening and Assessment in Prediction of Post Operative Complications and Hospital Readmission in Patients Undergoing Abdominal Surgery
• Preoperative Nutritional Assessment for Predicting Complications Risk in Patients Undergoing Abdominal Surgery

Study record dates

Study Major Dates

• Study Start (Actual): January 5, 2013
• Primary Completion (Actual): October 10, 2017
• Study Completion (Actual): December 20, 2017

Study Registration Dates

• First Submitted: October 22, 2018
• First Submitted That Met QC Criteria: October 23, 2018
• First Posted (Actual): October 25, 2018

Study Record Updates

• Last Update Posted (Actual): July 23, 2020
• Last Update Submitted That Met QC Criteria: July 21, 2020
• Last Verified: July 1, 2020

More Information

Terms related to this study

• Keywords: Stomach Neoplasms; Colorectal Surgery; Abdominal Surgery; Nutritional assesment; Nutritional screening tools
• Other Study ID Numbers: 23/27-01-2014

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No