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Chinese Journal of Hepatic Surgery(Electronic Edition) ›› 2020, Vol. 09 ›› Issue (03): 221-226. doi: 10.3877/cma.j.issn.2095-3232.2020.03.006

Special Issue:

• Clinical Research • Previous Articles     Next Articles

Comparison of two nutritional risk screening methods in perioperative period of hepatectomy for hepatocellular carcinoma under model of enhanced recovery after surgery

Peng Song1, Liang Mao2, Xiaojie Bian2, Tie Zhou2, Yinyin Fan2, Jing Zhang2, Shiquan Sun2, Xiaopeng Yan2, Xu Fu2, Yudong Qiu3,()   

  1. 1. Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210008, China
    2. Department of Hepatobiliary and Pancreatic Surgery, Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing 210008, China
    3. Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210008, China; Department of Hepatobiliary and Pancreatic Surgery, Nanjing Drum Tower Hospital affiliated to Nanjing University Medical School, Nanjing 210008, China
  • Received:2020-03-06 Online:2020-06-10 Published:2020-06-10
  • Contact: Yudong Qiu
  • About author:
    Corresponding author: Qiu Yudong, Email:

Abstract:

Objective

To compare the efficiency of nutritional risk screening 2002 (NRS2002) and patient-generated subjective global assessment (PG-SGA) in hepatectomy for hepatocellular carcinoma (HCC) under the model of enhanced recovery after surgery (ERAS).

Methods

Clinical data of 90 patients undergoing hepatectomy in Nanjing Drum Tower Hospital from January 2014 to July 2018 were retrospectively analyzed. Among them, 75 patients were male and 15 female, aged 35-74 years old with a median age of 60 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. Prior to surgery, all patients were divided into the malnutrition risk and normal nutrition groups according to the NRS2002 and PG-SGA scores. The nutritional indexes between two groups were statistically compared by t test. The incidence of postoperative complications was compared by Chi-square test or Fisher's exact probability test.

Results

The preoperative average grip strength in NRS2002 malnutrition risk group was (29±8) kg, significantly less than (34±7) kg in normal nutrition group (t=-2.364, P<0.05). The incidence of postoperative complications in NRS2002 malnutrition risk group was 73%(11/15) and the incidence of pulmonary infection was 27%(4/15), significantly higher compared with 43%(32/75) and 4%(3/75) in normal nutrition group (χ2=4.712, 8.954; P<0.05). The incidence of postoperative pulmonary infection in malnutrition risk group by PG-SGA was 15%(3/20), significantly higher than 6%(4/70) in the normal nutrition group (χ2=0.041, P<0.05).

Conclusions

Compared with PG-SGA score, preoperative NRS2002 score can more accurately reflect the preoperative nutritional status of patients and more effectively predict the risk of postoperative complications under the model of ERAS of hepatectomy.

Key words: Nutritional status, Hepatectomy, Postoperative complications, Perioperative care

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