Effect of Preoperative Nutritional Status on Surgical Site Infection in Colorectal Cancer Resection

Dig Surg. 2017;34(1):68-77. doi: 10.1159/000448123. Epub 2016 Jul 28.

Abstract

Background/aims: Postoperative complications of colorectal cancer (CRC) can sometimes be life threatening. Prevention of morbidity is therefore the most important issue, and among such complications, surgical site infections (SSIs) are the most critical. Predictive factors for SSI were evaluated.

Patients and methods: This was a retrospective study of 432 patients with CRC. SSIs were classified into incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs).

Results: Preoperative serum albumin (relative risk (RR) 2.51, p = 0.01) and body mass index (BMI: RR 2.36, p = 0.02) were the independent risk factors for iSSIs, while rectal cancer (RR 6.34, p < 0.0001), preoperative serum albumin (RR 7.03, p = 0.004), age (RR 2.71, p = 0.02), and male sex (RR 2.41, p = 0.05) were the independent risk factors for o/sSSIs. Patients with both low serum albumin and high BMI had the highest incidence of iSSIs (34.2%), and the group with rectal cancer and low serum albumin had the highest incidence of o/sSSIs (57.1%).

Conclusions: Preoperative nutritional status is a risk factor for SSIs in CRC, and its proper preoperative management may reduce the risk of SSIs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index*
  • Colonic Neoplasms / blood
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Incidence
  • Length of Stay
  • Male
  • Middle Aged
  • Models, Statistical*
  • Nutritional Status*
  • Preoperative Period
  • Probability
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / surgery*
  • Retrospective Studies
  • Risk Factors
  • Serum Albumin / metabolism*
  • Sex Factors
  • Surgical Wound Infection / epidemiology*

Substances

  • Serum Albumin