Advances in Clinical and Experimental Medicine

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Advances in Clinical and Experimental Medicine

2018, vol. 27, nr 8, August, p. 1141–1147

doi: 10.17219/acem/89863

Publication type: original article

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Correlation between malnutrition, body mass index and complications in patients with urinary bladder cancer who underwent radical cystectomy

Marta Swalarz1,A,B,C,D, Grzegorz Swalarz2,B,D, Kajetan Juszczak3,B,C,E,F, Piotr Maciukiewicz3,B, Krzysztof Czurak4,B, Marcin Matuszewski4,B, Dominika Gajewska5,B, Marcin Słojewski5,B, Rafał Bogacki6,B, Piotr Bryniarski6,A,B,C,E,F, Andrzej Paradysz6,A,B, Mateusz Kadłubowski7,B, Tomasz Drewa7,A,B, Ewa Genge8,C,E,F

1 Silesian Center of UROVITA, Chorzów, Poland

2 Department of Surgery and Urology, Upper Silesian Child Health Center, Katowice, Poland

3 Department of Urology, Memorial Rydygier Hospital, Kraków, Poland

4 Department of Urology, University Clinical Centre, Gdańsk, Poland

5 Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland

6 Department of Urology, Medical University of Silesia, Zabrze, Poland

7 Division of General and Oncological Urology, Specialized Municipal Hospital, Toruń, Poland

8 Department of Economic and Financial Analysis, University of Economics, Katowice, Poland

Abstract

Background. Nutrition is the 3rd most important factor in surgery, following anesthesia and asepsis. Until now, it has been a poorly explored field of urology. The relationship between malnutrition and postoperative complications has been proven beyond doubt in general surgery, where 30% of patients are operated in a malnutrition state.
Objectives. The aim of our work was to assess the influence of malnutrition, defined by nutritional risk screening (NRS) scale and body mass index (BMI), on postoperative results in patients with bladder cancer after radical cystectomy.
Material and Methods. The research was carried out at 8 urological centers between 2012 and 2014, and included patients with bladder cancer at stage from T2 to T4, who underwent radical cystectomy. The degree of malnutrition was assessed with the aid of the NRS 2002 questionnaire. Other examined parameters were BMI, age, type of operation, and the number of complications, the latter of which were measured by applying the Clavien-Dindo scale.
Results. A total of 125 patients were enrolled in our study, out of whom 64 (51.2%) were undernourished. According to the BMI, most of the patients were overweight – 50 (40%) or had normal body weight – 49 (39.2%); 24 (19.2%) were obese, and 2 (1.6%) were underweight.
Conclusion. There was no relationship between malnutrition, defined by the NRS scale, and postoperative complications, and we did not find a significant relationship between the other tested variables. We observed only 1 significant relationship between the nutrition state, measured by BMI scale, and the degree in Clavien-Dindo scale. Body mass index under 18.5 and over 30 increased postoperative complications. Nowadays, the recommended scale is NRS 2002, which is based mostly on loss of weight. In our patients, qualitative malnutrition is more probable than quantitative malnutrition.

Key words

malnutrition, bladder cancer, postoperative complications, radical cystectomy, Clavien-Dindo scale

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