Impact Of Preoperative Nutritional Risk On Complications After Radical Cystectomy

Background:As the development of surgical technologies and the post-operation rehabilitation, the nutrition risk as one of important indexes to assess the prognosis of patients, has got more attention by surgeons and patients. To evaluate whether urological patients at nutritional risk are at higher risks for more complications after the radical cystectomy than whom without nutritional risk.Methods and materials:We performed a retrospective observational study in consecutive patients undergoing radical cystectomy between 2010 and 2013. The basic characteristics and biochemical data were collected. The nutritional risk score was assessed preoperatively by a specialized nurse. Patients with NRS (nutritional risk screening, NRS2002) scores≥3 were considered to have nutritional deficiency. Postoperative complications were defined using the standardized Clavien-Dindo classification. Univariate and multivariate analysis was performed to identify predictors of complications.Results:Patients aged more than 70 years (50.57%) are more prone to nutritional risk than that aged less than 70 years (31.67%) (P=0.023). Of all 63 patients at nutritional risk before operation,39 (61.90%) presented with at least 1 complications compared to 29 cases of 84 controls (34.52%) (P-0.001). Patients with higher nutritional risks peri-operation, anemia and hypoalbuminemia were more susceptible to the occurance of postoperation associated complications (nutritional risk: OR=3.128,95%CI 1.538～6.361, P=0.002; anemia:OR=2.904,95%CI:1.233-5.099, P=0.033; hypoalbuminemia:OR=3.001,95%CI:1.194-4.923,P=0.049). In addition, length of hospital stay of patients at higher nutritional risk peri-operation was significantly longer than that without nutritional risk (Nutritional risk group:12.9±5.7 d; non-nutritional risk:10.4±4.3 d, P=0.0027).Conclusions:Patients aged more than 70 years are more prone to higher nutritional risk before operation than those aged less than 70 years. Patients with higher nutritional risks, anemia and hypoalbuminemia were more susceptible to the occurance of postoperation associated complications. Patients with higher nutritional risks peri-operation are suffering from longer length of hospital stay.