Preoperative nutritional status predicts the severity of the systemic inflammatory response syndrome (SIRS) following major vascular surgery
Preoperative nutritional status predicts the severity of the systemic inflammatory response syndrome (SIRS) following major vascular surgery
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DOI：
10.1016/j.ejvs.2006.12.006
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发表时间：
2007-06-01
影响因子：
5.7
通讯作者：
Fitridge, R. A.
中科院分区：
文献类型：
--
作者：
Hassen, T. A.;Pearson, S.;Fitridge, R. A.
目标。本研究探讨了术前营养状况与大血管手术后全身性炎症反应综合征（SIRS）或败血症的关系。设计和方法。接受开放式AAA修复、EVAR或下肢血运重建术的受试者进行前瞻性研究。采用mini - nutrition Assessment （MNA）临床评估术前营养状况，采用双能x线吸收仪（DEXA）扫描测量体成分。术后5天评估SIRS严重程度，术后30天评估脓毒症。使用MNA，在“营养良好”的受试者和“有营养不良风险”的受试者之间，SIRS的严重程度和败血症的发生率都没有显著差异。使用DEXA，体重指数与SIRS评分和SIRS持续时间之间存在负相关。无脂质量（FFM）与SIRS评分和持续时间呈负相关。骨骼肌质量（SMM）与SIRS评分和持续时间也存在负相关。SMM与术后住院时间也呈负相关。脓毒症与任何营养指标均无显著相关性。较低的术前营养指数（表明蛋白质能量营养不良）与大血管手术后更严重的全身炎症反应相关。
Objectives. This study examined the relationship between pre-operative nutritional status and systemic inflammatory response syndrome (SIRS) or sepsis following major vascular surgery.Design and methods. Subjects undergoing open AAA repair, EVAR or lower limb revascularisation were studied prospectively. Pre-operative nutrition was assessed clinically using Mini-Nutritional Assessment (MNA) and body composition was measured by dual energy X-ray absorptiometry (DEXA) scanning. SIRS severity was assessed for 5 post-operative days and sepsis noted within 30 days of surgery.Results. Using MNA, neither SIRS severity nor sepsis occurrence differed significantly between 'well-nourished' subjects and those 'at risk of malnutrition'. Using DEXA, negative associations existed between body mass index and both SIRS score and SIRS duration. Fat free mass (FFM) was negatively associated with SIRS score and duration. Negative associations also existed between skeletal muscle mass (SMM) and SIRS score and duration. SMM was also negatively correlated with post-operative length of stay in hospital. There were no significant correlations between sepsis and any nutritional indices.Conclusions. Lower pre-operative nutritional indices, indicating protein energy malnutrition, were associated with more severe systemic inflammatory responses following major vascular surgery.