Outcome of preoperative weight loss in colorectal surgery

Background There 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. Methods The 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. Results We 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. Conclusions A 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.