Preoperative nutritional factors as predictors of postoperative early outcomes in colorectal cancer - A prospective cohort study.

Introduction

in colorectal cancer (CRC) surgery, preoperative nutritional factors are often overlooked or underestimated. This situation represents a significant deficiency that may negatively affect patients' postoperative recovery processes.

Objective

the objective of this study was to evaluate the impact of preoperative malnutrition, sarcopenia, obesity, and dietary inflammatory potential on early postoperative outcomes in CRC.

Methods

preoperative sarcopenia was identified using European Working Group on Sarcopenia in Older People (EWGSOP2) criteria based on skeletal muscle obtained from computed tomography (CT) scans, and malnutrition was identified using Global Leadership Initiative on Malnutrition (GLIM) criteria. Visceral and subcutaneous obesity were assessed using CT scans. The energy-adjusted dietary inflammatory index (E-DII) was calculated from dietary records.

Results

a total of 121 patients were included in the study, and 45.5 % of them were malnourished according to GLIM, 15.7 % were sarcopenic according to EWGSOP2. Multivariate logistic regression analysis showed that sarcopenia [OR = 3.973 (1.028-15.353), p = 0.043], malnutrition [OR = 3.954 (1.479-10.575), p = 0.006], and E-DII [OR = 4.955 (1.397-17.571), p = 0.013] were independent risk factors for complications. Sarcopenia [OR = 6.894 (1.080-43.998), p = 0.041] was also risk factor for long-term hospitalization.

Conclusion

a comprehensive evaluation of preoperative nutrition and related factors in CRC surgery, along with timely interventions, has the potential to significantly reduce postoperative complications and length of hospital stays.