Outcome of preoperative weight loss in colorectal surgery

• Preoperative weight loss has an incidence of 3% in colorectal surgery.
• Preoperative weight loss is associated with increased morbidity and mortality.
• A history of weight loss can be used as a marker for nutritional assessment.
• Cardiopulmonary complications have significant association with preoperative weight loss.
• Crohn’s disease has the highest risk of weight loss in colorectal surgery.

BackgroundThere are limited data regarding the outcomes of patients with preoperative weight loss. We sought to identify complications associated with preoperative weight loss in colorectal surgery.MethodsThe National Surgical Quality Improvement Program database was used to examine the clinical data of patients undergoing colorectal resection from 2005 to 2012 who had unintentional preoperative weight loss (more than 10% in 6 months of surgery). Multivariate analysis was performed to quantify the association of weight loss with postoperative complications.ResultsWe sampled a total of 79,696 patients who were admitted nonemergently for colorectal resection. The rate of preoperative unintentional weight loss was 3%. There were associations between preoperative weight loss with preoperative hypoalbuminemia (serum albumin level < 3.5 g/dL) (adjusted odds ratio [AOR] 2.58, P < .01). Postoperative mortality (AOR 1.74, P < .01) and complications of myocardial infarction (AOR 1.97, P = .03) and ventilator dependency (AOR 1.54, P = .03) had strong associations with weight loss.ConclusionsA history of unintentional weight loss can be used to predict mortality and morbidity rates and as a marker for nutritional assessment in colorectal surgery. Cardiopulmonary complications have significant association with preoperative weight loss.