Öz
Amaç: Genel
cerrahi servisine yatırılan benign ve malign hastalığı olan hastalardaki
malnutrisyon sıklığını saptamak, malnutrisyonun tanınmasında kullanılan
yöntemleri değerlendirmek ve malnutrisyonun postoperatif komplikasyon
gelişimindeki rolünü incelemektir.
Hastalar
ve Yöntem: Şubat 2004 – Mayıs 2005 tarihleri arasında Genel Cerrahi
kliniği’nde opere edilen 723 hastada, beş ayrı yöntemle (nutrisyonel risk
indeksi, subjektif global değerlendirme, kilo kaybı oranı, serum albümin
düzeyi, vücut kitle indeksi ) malnutrisyon sıklığı araştırıldı. Medikal tedavi
alan hastalar çalışmaya dahil edilmedi. Hastalar uygulanan nutrisyonel destek,
komplikasyon ve mortalite yönünden takip edildi.
Bulgular: Toplam
malnutrisyon oranı %30.5, ağır malnutrisyon oranı %8.9 olarak tespit edildi.
Benign hastalığı olanlarda %25.8, malign hastalığı olanlarda ise %53.3
malnutrisyon saptandı. Toplam ve hafif malnutrisyonu tespit etmede en yüksek
sıklık, Nutrisyonel Risk İndeksi ile elde edildi. Ağır malnutrisyonu tanımada
yöntemler arasında fark saptanmadı. Malnutrisyonu olmayan hastalarda
%10.9, malnutrisyonu olan hastalarda ise
%28.6 oranında komplikasyon gelişti.
Sonuç:
Malnutrisyon, cerrahi hastalarda sık karşılaşılan, komplikasyon ve mortalite
riskini önemli derecede arttıran klinik problemlerden birisidir. Preoperatif
dönemde malnutrisyonun tespit edilerek, ihtiyaç gösteren hastalara nutrisyonel
desteğin uygulanması halinde, komplikasyon sıklığı önemli derecede
azaltılabilir.
Anahtar Kelimeler
Kaynakça
- 1- Vernon DR, Hill GL. The relationship between tissue loss and function:recent developments. Curr Opin Clin Nutr Metab Care 1998;1:5-8.
- 2- Bruun LI, Bosaeus I, Bergstad I, et al. Prevelance of malnutrition in surgical patients: evaluation of nutritional support and documentation. Clin Nutr 1999;18:141-147.
- 3- Wu GH, Liu ZH, Zheng LW, et al. Prevelance of malnutrition in general surgical patients: evaluation of nutritional status and prognosis. Zhonghua Wai Ke Za Zhi 2005;43:693-696.
- 4- Correia MI, Caiaffa WT, da Silva AL, et al. Risk factors for malnutrition in patients undergoing gastroeneterological and hernia surgery: an analysis of 374 patients. Nutr Hosp 2001;16:59-64.
- 5- Sungurtekin H, Sungurtekin U, Hancı V, ve ark. Comparision of two nutrition assessment techniques in hospitalised patients. Nutrition 2004;20:428-432.
- 6- Nursal TZ, Noyan T, Atalay BG, ve ark. Simple two-part tool for screening of malnutrition. Nutrition 2005;21:65-69.
- 7- Green SM, Watson R. Nutritional Screening and assessment tools for use by nurses:literature review. J Adv Nurs 2005;50:69-83.
- 8- Delmore G. Assessment of nutritional status in cancer patients: widely neglected? Support Care Cancer 1997;5:376-380.
- 9- Pirlich M, Lochs H. Nutrition in the elderly. Best Pract Res Clin Gastroenterol 2001;15:869-884.
- 10- Detsky AS, McLaughlin JR, Baker JP ET AL. Evaluating the accuracy of nutritional assessment techniques applied to hospitalised patients:methodology and comparisons. JPEN 1984;8:153-159.
- 11- Hill GL, Witney GB, Christie PM, et al. Protein status and metabolic expenditure determine the response to intravenous nutrition-a new classification of surgical malnutrition. Br J Surg 1991;78:109-113.
- 12- Wındsor JA, Knight GS, Hill GL. Wound healing response in surgical patients: recent food intake is more important than nutritional status. Br J Surg 1988;75:135-137.
- 13- Detsky AS, Baker JP, O’Rourke K, et al. Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med 1987;107:195-203.
- 14- Meakins JL, Christou NV, Shizgal HM, et al. Therapeutic approaches to anergy in surgical patients. Surgery and levamisole. Ann Surg 1979;190:286-296.
- 15-Naber TH, Schermer T, de Bree A, et al. Prevalence of malnutrition in nonsurgical hospitalised patients and its association with disease complications. AM J Clin Nutr 1997;66:1232-1239.
- 16- Mullen JL, Buzby GP, Matthews DC, et al. Reduction of operative morbidity and mortality by combined peroperative and psotoperative nutritional support. Ann Surg 1980;192:604-613.
- 17- Klidjan AM, Archer TJ, Foster KJ, ET AL. Detection of dangerous malnutrition.JPEN 1982;6:119-121.
Öz
Aim: To
determine the frequency of malnutrition in patients with benign and malignant
disease admitted to the general surgery service, evaluate the methods used in
recognition of malnutrition and to investigate the role of malnutrition in the
development of postoperative complications.
Patients and Method: Between February 2004 and May 2005, in 723 patients,
who were operated in General Surgery Department, frequency of malnutrition was
detected five different methods (Nutrition Risk Index, Subjective Global Assessment,
rate of weight loss, serum albumin level, Body Mass Index). Medically treated patients
were excluded. Patients were followed for nutritional support, complication and
mortality.
Results:
In 723 patients, total malnutrition rate was detected 30.5% and severe
malnutrition rate was 8.9%. Patients with benign diseases, had a malnutrition
rate of 25.8% despite patients with malign diseases, had a rate of 53.3%. We
got highest frequencies r to determinate total and mild malnutrition with
Nutritional Risk Index. For severe malnutrition, there was no differences
between the methods. Complication rates were 10.9% for not malnourished
patients and 28.6% for malnourished patients.
Conclusion: Malnutrition is a common clinical problem in surgical
patients that increases complication and mortality risks. Preoperatively
detection of malnutrition and giving nutritional support to malnourished
patients, may decrease complication rates.
Anahtar Kelimeler
Kaynakça
- 1- Vernon DR, Hill GL. The relationship between tissue loss and function:recent developments. Curr Opin Clin Nutr Metab Care 1998;1:5-8.
- 2- Bruun LI, Bosaeus I, Bergstad I, et al. Prevelance of malnutrition in surgical patients: evaluation of nutritional support and documentation. Clin Nutr 1999;18:141-147.
- 3- Wu GH, Liu ZH, Zheng LW, et al. Prevelance of malnutrition in general surgical patients: evaluation of nutritional status and prognosis. Zhonghua Wai Ke Za Zhi 2005;43:693-696.
- 4- Correia MI, Caiaffa WT, da Silva AL, et al. Risk factors for malnutrition in patients undergoing gastroeneterological and hernia surgery: an analysis of 374 patients. Nutr Hosp 2001;16:59-64.
- 5- Sungurtekin H, Sungurtekin U, Hancı V, ve ark. Comparision of two nutrition assessment techniques in hospitalised patients. Nutrition 2004;20:428-432.
- 6- Nursal TZ, Noyan T, Atalay BG, ve ark. Simple two-part tool for screening of malnutrition. Nutrition 2005;21:65-69.
- 7- Green SM, Watson R. Nutritional Screening and assessment tools for use by nurses:literature review. J Adv Nurs 2005;50:69-83.
- 8- Delmore G. Assessment of nutritional status in cancer patients: widely neglected? Support Care Cancer 1997;5:376-380.
- 9- Pirlich M, Lochs H. Nutrition in the elderly. Best Pract Res Clin Gastroenterol 2001;15:869-884.
- 10- Detsky AS, McLaughlin JR, Baker JP ET AL. Evaluating the accuracy of nutritional assessment techniques applied to hospitalised patients:methodology and comparisons. JPEN 1984;8:153-159.
- 11- Hill GL, Witney GB, Christie PM, et al. Protein status and metabolic expenditure determine the response to intravenous nutrition-a new classification of surgical malnutrition. Br J Surg 1991;78:109-113.
- 12- Wındsor JA, Knight GS, Hill GL. Wound healing response in surgical patients: recent food intake is more important than nutritional status. Br J Surg 1988;75:135-137.
- 13- Detsky AS, Baker JP, O’Rourke K, et al. Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med 1987;107:195-203.
- 14- Meakins JL, Christou NV, Shizgal HM, et al. Therapeutic approaches to anergy in surgical patients. Surgery and levamisole. Ann Surg 1979;190:286-296.
- 15-Naber TH, Schermer T, de Bree A, et al. Prevalence of malnutrition in nonsurgical hospitalised patients and its association with disease complications. AM J Clin Nutr 1997;66:1232-1239.
- 16- Mullen JL, Buzby GP, Matthews DC, et al. Reduction of operative morbidity and mortality by combined peroperative and psotoperative nutritional support. Ann Surg 1980;192:604-613.
- 17- Klidjan AM, Archer TJ, Foster KJ, ET AL. Detection of dangerous malnutrition.JPEN 1982;6:119-121.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Cerrahi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 12 Mart 2018 |
| Gönderilme Tarihi | 28 Ocak 2018 |
| Kabul Tarihi | 6 Şubat 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 2 Sayı: 1 |
Cited By
Risk of malnutrition in general surgical patients
Journal of Health Sciences and Medicine
https://doi.org/10.32322/jhsm.823458
Malnutrition In Surgery Patients Within The Framework Of The Eras Protocols
Türkiye Sağlık Bilimleri ve Araştırmaları Dergisi
https://doi.org/10.51536/tusbad.1098697
Is There a Correlation Between NRS-2002 and EAT-10 Score?
Topics in Clinical Nutrition
https://doi.org/10.1097/TIN.0000000000000277
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