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Anaesthesiology Intensive Therapy
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1/2024
vol. 56
 
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abstract:
Original article

Nutritional responsiveness affects novel neutrophil parameters and reduces in-hospital mortality and costs in elective cancer oesophagectomy – a single centre, prospective, observational study

Paweł Kutnik
1
,
Michał Borys
1
,
Kamil Nurczyk
2
,
Weronika Domerecka
3
,
Jacek Dziedzic
2
,
Grzegorz Buszewicz
4
,
Grzegorz Teresiński
5
,
Helena Donica
6
,
Paweł Piwowarczyk
1
,
Mirosław Czuczwar
1

  1. 2nd Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland
  2. 2nd Department of General and Gastrointestinal Surgery, and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Lublin, Poland
  3. Department of Laboratory Diagnostics, University Teaching Hospital No 1 in Lublin, Poland
  4. Laboratory of Forensic Toxicology, Department of Forensic Medicine, Medical University of Lublin, Lublin, Poland
  5. Department of Forensic Medicine, Medical University of Lublin, Lublin, Poland
  6. Department of Biochemical Diagnostics, Chair of Laboratory Diagnostics, Medical University of Lublin, Lublin, Poland
Anaesthesiol Intensive Ther 2024; 56, 1: 77–82
DOI: https://doi.org/10.5114/ait.2024.136013
Online publish date: 2024/03/07
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Introduction:
Malnutrition in surgical patients remains a common issue affecting the perioperative period. Oesophageal cancer is a disease associated with one of the highest malnutrition rates. Assessment of patient nutritional status remains a challenge due to limited validated tools. Novel parameters to identify malnourished patients and the effectiveness of preoperative nutritional intervention might improve treatment results in the perioperative period.

Material and methods:
This was a prospective, observational, single-centre study of patients scheduled for elective oesophagectomy. The primary aim of this study was to establish the correlation between neutrophil reactivity intensity (NEUT-RI) and neutrophil granularity intensity (NEUT-GI) and patients’ nutritional status. We divided patients into nutritional responders (R group) and nutritional non-responders (NR group) defined as regaining at least 25% of the maximum preoperative body weight loss during the preoperative period.

Results:
The R group had significantly shorter intensive care unit (ICU) stays: 5.5 (4–8) vs. 13 (7–31) days (P = 0.01). It resulted in a lower cost of ICU stays in the R group: 4775.2 (3938.9–7640.7) vs. 12255.8 (7787.6–49108.7) euro in the NR group (P = 0.01). Between the R group and the NR group, we observed statistically significant differences in both preoperative NEUT-RI (48.6 vs. 53.4, P = 0.03) and NEUT-GI (154.6 vs. 159.3, P = 0.02). Apart from the T grade, the only preoperative factor associated with reduced mortality was the nutritional responsiveness: 11.1% vs. 71.4% (P = 0.008).

Conclusions:
Preoperative nutritional responsiveness affects neutrophil intensity indexes and reduces in-hospital mortality and costs associated with hospital stay. Further research is required to determine the correlation between novel neutrophil parameters and patients’ nutritional status.

keywords:

malnutrition, oesophageal cancer, oesophagectomy, perioperative nutrition, GLIM, oesophago-gastric junction cancer, NEUT-RI, NEUT-GI
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