Utility of nutritional evaluation for the clinical risk assessment of postoperative complications. Does oncology need the NRS 2002 scale?

Abstract

Introduction. Malnutrition accompanies many cancers, especially those of the gastrointestinal tract, and significantly raises the risk of postoperative complications in cancer surgery. In Poland, hospitals are legally obliged to evaluate the nutritional status of their patients; one of the assessment tools used for this purpose is the NRS 2002 scale. Aim. The primary objective of the study is to analyze the utility of the NRS 2002 scale in the risk assessment of posto­perative complications in gastrointestinal cancers. In addition, the authors propose to determine whether the legal requirement to conduct nutritional assessments among hospitalized patients is complied with in clinical practice and to evaluate the risk of malnutrition in the study group. Materials and methods. A detailed assessment was conducted on 226 patients who underwent surgery for upper (95 patients) and lower (131 patients) GI tract cancers in 2015. The risk of complications was analyzed based on the nutritional risk score (NRS 2002) and the levels of albumin and total proteins in the serum before surgery. Compliance with the obligation to carry out nutritional assessments was evaluated on breast and GI cancer patients treated with surgery at the Institute of Oncology in Warsaw in two successive years. Results. An NRS 2002 score of ≥ 3 was shown to predict postoperative complications for both upper GI tract (p < 0.001) and colorectal cancers (p < 0.001). In upper GI cancers, complications were also more frequently observed at lower albumin (p = 0.018) and total protein (p = 0.025) levels in the serum. Conclusion. The analysis shows that the NRS 2002 scale is useful in predicting the risk of postoperative complications in the treatment of upper and lower GI tract cancers.