The impact of nutritional status on the outcome of lung volume reduction surgery

A prospective study

Peter Mazolewski, J. Turner, Mindy Baker, Terry Kurtz, Alex G. Little

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Objectives: To study the incidence and clinical significance of nutritional deficiencies in patients with emphysema undergoing lung volume reduction surgery (LVRS). Design: Prospective observational study. Setting: University-based teaching hospital. Patients: Fifty-one consecutive patients with end-stage emphysema undergoing video-assisted thoracoscopic surgery for LVRS. Interventions: All patients had their body mass index (BMI) and serum nutritional indexes (albumin, transferrin, total protein, cholesterol) measured preoperatively and postoperatively. Various clinical parameters were also compared between two groups. Results: The BMI was normal in 24 patients (47%), and 27 patients (53%) had a below normal BMI. A preoperative analysis of the serum nutritional indexes revealed no clinically significant differences between the two groups, but postoperative levels were significantly lower in the low BMI group. Anthropometric measurements supported the designation of nutritional status by BMI. Clinically, 26% of the patients in the low BMI group required prolonged ventilatory support (> 24 h), compared to only 4% of the patients with a normal BMI. The hospital length of stay (LOS) also differed, averaging 15.9 days in the low BMI group, compared to an average of 11.8 days in the normal BMI group. Conclusion: Approximately 50% of patients undergoing LVRS for emphysema have a deficient nutritional status identifiable by BMI, but not by standard nutritional indexes. This impaired nutritional status is associated with increased morbidity following LVRS. We suggest that BMI is an accurate determinant of nutritional status in this patient population, and we speculate that preoperative repletion of nutritional deficiencies may decrease hospital morbidity, hospital LOS, and overall costs in the malnourished population undergoing LVRS.

Original languageEnglish (US)
Pages (from-to)693-696
Number of pages4
JournalChest
Volume116
Issue number3
DOIs
StatePublished - Jan 1 1999

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Pneumonectomy
Nutritional Status
Body Mass Index
Prospective Studies
Nutrition Assessment
Length of Stay
Emphysema
Malnutrition
Morbidity
Video-Assisted Thoracic Surgery
Transferrin
Serum
Teaching Hospitals
Population
Observational Studies
Albumins
Cohort Studies
Cholesterol
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

The impact of nutritional status on the outcome of lung volume reduction surgery : A prospective study. / Mazolewski, Peter; Turner, J.; Baker, Mindy; Kurtz, Terry; Little, Alex G.

In: Chest, Vol. 116, No. 3, 01.01.1999, p. 693-696.

Research output: Contribution to journalArticle

Mazolewski, Peter ; Turner, J. ; Baker, Mindy ; Kurtz, Terry ; Little, Alex G. / The impact of nutritional status on the outcome of lung volume reduction surgery : A prospective study. In: Chest. 1999 ; Vol. 116, No. 3. pp. 693-696.
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