The Role of Nutritional Access in Malnourished Elderly Undergoing Major Surgery for Acute Abdomen: A Propensity Score-Matched Analysis.
acute abdomen
elderly
gastrostomy
jejunostomy
major surgery
Journal
The American surgeon
ISSN: 1555-9823
Titre abrégé: Am Surg
Pays: United States
ID NLM: 0370522
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
pubmed:
22
12
2020
medline:
30
9
2021
entrez:
21
12
2020
Statut:
ppublish
Résumé
About 50% of the elderly undergoing emergency abdominal surgery are malnourished. The role of timely surgical nutritional access in this group of patients is unknown. We analyzed the National Inpatient Sample database from 2009 through the first three-quarters of 2015 of patients aged ≥65 years who were malnourished and underwent major abdominal surgery for the acute abdomen within the first 2 days of hospital admission. Of 3 246 721 patients analyzed, 4311 patients met inclusion criteria. Of these, only 507 (11.8%) patients had surgical nutritional access (gastrostomy or jejunostomy) (group I), while 3804 patients (88.2%) did not (group II). In the propensity score-matched population, there were 482 patients in each group. The patients in group I had lower odds of mortality and postoperative gastrointestinal complications (paralytic ileus, anastomotic dehiscence, and intestinal fistulae) ( Elderly who receive surgical nutritional access have lower rates of gastrointestinal complications and mortality.
Sections du résumé
BACKGROUND
BACKGROUND
About 50% of the elderly undergoing emergency abdominal surgery are malnourished. The role of timely surgical nutritional access in this group of patients is unknown.
METHODS
METHODS
We analyzed the National Inpatient Sample database from 2009 through the first three-quarters of 2015 of patients aged ≥65 years who were malnourished and underwent major abdominal surgery for the acute abdomen within the first 2 days of hospital admission.
RESULTS
RESULTS
Of 3 246 721 patients analyzed, 4311 patients met inclusion criteria. Of these, only 507 (11.8%) patients had surgical nutritional access (gastrostomy or jejunostomy) (group I), while 3804 patients (88.2%) did not (group II). In the propensity score-matched population, there were 482 patients in each group. The patients in group I had lower odds of mortality and postoperative gastrointestinal complications (paralytic ileus, anastomotic dehiscence, and intestinal fistulae) (
DISCUSSION
CONCLUSIONS
Elderly who receive surgical nutritional access have lower rates of gastrointestinal complications and mortality.
Identifiants
pubmed: 33345560
doi: 10.1177/0003134820973719
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM