Factors predicting nutritional derangements in patients with obstructive jaundice: multivariate analysis

World Journal of Surgery
F J PadilloC Pera-Madrazo

Abstract

Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign obstructions). A nutritional risk index of < 83.5 was used to define protein-calorie malnutrition. Liver function, cholecystokinin (CCK), tumor necrosis factor-alpha (TNFalpha), and endotoxin levels were determined. A multivariate analysis was performed, and an obstructive jaundice malnutrition index (OJMI) was obtained. Altogether, 22 (48%) OJ patients had malnutrition (33% with benign obstructions, 57% with malignant disease). Malnourished patients had higher serum bilirubin levels (258 +/- 120 vs. 154 +/- 62 mmol/L; p = 0.005), longer duration of jaundice (16 +/- 9 vs. 9 +/- 5 days; p = 0.03), and higher plasma levels of CCK (4.0 +/- 1.3 vs. 1.7 +/- 1.0 pmol/L; p = 0.005), alanine aminotransferase (ALT) (226 +/- 209 vs. 187 +/- 161 UI/L; p = 0.01), endotoxin (15 +/- 10 vs. 6.5 +/- 7.0 EU/L; p = 0.007), and TNFalpha (69 +/- 82 vs. 23 +/- 15 pg/ml; p = 0.008) than those without malnutrition. However, only serum b...Continue Reading

Citations

Jul 14, 2004·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·H GerkeJ Baillie
Nov 15, 2002·Nutrition·F J PadilloA Sitges-Serra
Feb 23, 2013·Nutrients·Salim AbunnajaJuan A Sanchez
May 26, 2009·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·M BragaUNKNOWN ESPEN
Aug 4, 2005·The British Journal of Surgery·F J PadilloA Sitges-Serra
May 6, 2006·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·April ClugstonRowan W Parks
May 16, 2006·Clinical Nutrition : Official Journal of the European Society of Parenteral and Enteral Nutrition·A WeimannUNKNOWN ESPEN (European Society for Parenteral and Enteral Nutrition)
Jun 15, 2013·Journal of the American College of Radiology : JACR·Charles E RayGeorge Vatakencherry
Oct 24, 2014·World Journal of Gastroenterology : WJG·José M AlamoFrancisco J Padillo
May 1, 2021·Cancers·Sarah Powell-BrettKeith J Roberts

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