[ Vol. 9 No. 2 ] (May - August 2008 )
Nutrition screening tools and the prediction of postoperative infectious and wound complications

Panwadee Putwatana1,  Panuwat Lertsithichai2, Pinmanee Reodecha2, Yupapin Sirapo-ngam2, Kanit Sumboonnanonda2
1Mahidol Univ./Faculty of Medicine, Ramathibodi Hospital, Thailand
2Faculty of Medicine, Ramathibodi Hospital, Mehidol Univ., Thailand


Objective: To compare four nutrition screening tools, Nutrition Risk Classification (NRC), Mini Nutrition Assessment-Short form (MNA-SA), Malnutrition screening Tool (MST), and Nutrition Risk Score (NRS), in term of the ability to predict postoperative wound and infectious complications when adjusted for the effects of other risk factor of postoperative infection.

Methods: A prospective cohort study was performed on 430 Patients under going abdominal surgery at a tertiary hospital during an 8-month period,. Data on the NRC, the MNA-SA, the MST, the NRS and well-known risk factors for infectious and wound complications were collected for all patients. Patients were followed till hospital death or till 30 days after operation. Nutrition screening tools were compared for their ability to predict postoperative complications using the area under the Receiver Operating Characteristic (ROC) curve. Multivariable adjustment for other risk factors of postoperative infections was using multiple logistic regression.

Results: The NRC had the highest ROC area. Only the NRC was significantly related to the occurrence of postoperative infectious and wound complications (Odds Ratio (95% Confidence Interval): 3.67 (1.88-7.10)) after adjusting for other risk factors of postoperative wound infection. The other remaining risk factors were albumin level and operative time.

Conclusions: The NRC seems to be the best nutrition screening tool for use in predicting postoperative infectious and wound complications. A scoring system combining the NRC and serum albumin level should be most accurate and useful for screening malnutrition status for purposes of predicting and hence preventing thesecomplications.

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The 11th PENSA Congress

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