Skip to main content
PMC home page
Thorax logoLink to Thorax
. 1990 Mar;45(3):183–186. doi: 10.1136/thx.45.3.183

Nutritional state of patients with lung cancer undergoing thoracotomy.

Y Bashir 1, T R Graham 1, A Torrance 1, G J Gibson 1, P A Corris 1
PMCID: PMC462379  PMID: 2109900

Abstract

Preoperative nutritional assessment was carried out on 39 consecutive patients with bronchial carcinoma who underwent thoracotomy. For 18 patients the body mass index and triceps and subscapular skinfold thickness fell below the 25th centile. In 23 patients the creatinine height index was less than 80% of the predicted value. The mean (SEM) serum albumin concentration was 40.3 (0.57) g/l (reference range 35-50 g/l) and mean (SEM) serum transferrin 1.77 (0.1) g/l (reference range 2.0-3.0 g/l). Although only three patients were hypoalbuminaemic, transferrin concentrations were depressed in 26 patients. There was a significant fall in the serum concentrations of both prealbumin and transferrin in the first postoperative week. Nutritional insufficiency was particularly severe in the four patients who developed an early bronchopleural fistula. It is concluded that protein-energy malnutrition is common in patients with operable bronchial carcinoma and that routine postoperative feeding does not prevent further depletion of circulating proteins. A larger prospective study is needed to examine the relation between preoperative nutritional state and outcome.

Full text

PDF
183

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bistrian B. R., Blackburn G. L., Hallowell E., Heddle R. Protein status of general surgical patients. JAMA. 1974 Nov 11;230(6):858–860. [PubMed] [Google Scholar]
  2. Bistrian B. R., Blackburn G. L., Sherman M., Scrimshaw N. S. Therapeutic index of nutritional depletion in hospitalized patients. Surg Gynecol Obstet. 1975 Oct;141(4):512–516. [PubMed] [Google Scholar]
  3. Buzby G. P., Mullen J. L., Matthews D. C., Hobbs C. L., Rosato E. F. Prognostic nutritional index in gastrointestinal surgery. Am J Surg. 1980 Jan;139(1):160–167. doi: 10.1016/0002-9610(80)90246-9. [DOI] [PubMed] [Google Scholar]
  4. Buzby G. P., Williford W. O., Peterson O. L., Crosby L. O., Page C. P., Reinhardt G. F., Mullen J. L. A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr. 1988 Feb;47(2 Suppl):357–365. doi: 10.1093/ajcn/47.2.357. [DOI] [PubMed] [Google Scholar]
  5. Cronk C. E., Roche A. F. Race- and sex-specific reference data for triceps and subscapular skinfolds and weight/stature. Am J Clin Nutr. 1982 Feb;35(2):347–354. doi: 10.1093/ajcn/35.2.347. [DOI] [PubMed] [Google Scholar]
  6. Davis D. R. Triumph over terror. Br Med J (Clin Res Ed) 1985 Nov 16;291(6506):1369–1370. doi: 10.1136/bmj.291.6506.1369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dempsey D. T., Mullen J. L., Buzby G. P. The link between nutritional status and clinical outcome: can nutritional intervention modify it? Am J Clin Nutr. 1988 Feb;47(2 Suppl):352–356. doi: 10.1093/ajcn/47.2.352. [DOI] [PubMed] [Google Scholar]
  8. Golden M. H. Transport proteins as indices of protein status. Am J Clin Nutr. 1982 May;35(5 Suppl):1159–1165. doi: 10.1093/ajcn/35.5.1159. [DOI] [PubMed] [Google Scholar]
  9. Grant J. P., Custer P. B., Thurlow J. Current techniques of nutritional assessment. Surg Clin North Am. 1981 Jun;61(3):437–463. doi: 10.1016/s0039-6109(16)42430-8. [DOI] [PubMed] [Google Scholar]
  10. Harvey K. B., Moldawer L. L., Bistrian B. R., Blackburn G. L. Biological measures for the formulation of a hospital prognostic index. Am J Clin Nutr. 1981 Oct;34(10):2013–2022. doi: 10.1093/ajcn/34.10.2013. [DOI] [PubMed] [Google Scholar]
  11. Haydock D. A., Hill G. L. Impaired wound healing in surgical patients with varying degrees of malnutrition. JPEN J Parenter Enteral Nutr. 1986 Nov-Dec;10(6):550–554. doi: 10.1177/0148607186010006550. [DOI] [PubMed] [Google Scholar]
  12. Heatley R. V., Williams R. H., Lewis M. H. Pre-operative intravenous feeding--a controlled trial. Postgrad Med J. 1979 Sep;55(646):541–545. doi: 10.1136/pgmj.55.646.541. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hill G. L. Malnutrition and surgical risk: guidelines for nutritional therapy. Ann R Coll Surg Engl. 1987 Nov;69(6):263–265. [PMC free article] [PubMed] [Google Scholar]
  14. Holroyde C. P., Reichard G. A., Jr General metabolic abnormalities in cancer patients: anorexia and cachexia. Surg Clin North Am. 1986 Oct;66(5):947–956. doi: 10.1016/s0039-6109(16)44034-x. [DOI] [PubMed] [Google Scholar]
  15. Mullen J. L., Buzby G. P., Matthews D. C., Smale B. F., Rosato E. F. Reduction of operative morbidity and mortality by combined preoperative and postoperative nutritional support. Ann Surg. 1980 Nov;192(5):604–613. doi: 10.1097/00000658-198019250-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mullen J. L. Consequences of malnutrition in the surgical patient. Surg Clin North Am. 1981 Jun;61(3):465–487. doi: 10.1016/s0039-6109(16)42431-x. [DOI] [PubMed] [Google Scholar]
  17. Mullen J. L., Gertner M. H., Buzby G. P., Goodhart G. L., Rosato E. F. Implications of malnutrition in the surgical patient. Arch Surg. 1979 Feb;114(2):121–125. doi: 10.1001/archsurg.1979.01370260011001. [DOI] [PubMed] [Google Scholar]
  18. Müller J. M., Brenner U., Dienst C., Pichlmaier H. Preoperative parenteral feeding in patients with gastrointestinal carcinoma. Lancet. 1982 Jan 9;1(8263):68–71. doi: 10.1016/s0140-6736(82)90212-4. [DOI] [PubMed] [Google Scholar]
  19. Rochester D. F., Esau S. A. Malnutrition and the respiratory system. Chest. 1984 Mar;85(3):411–415. doi: 10.1378/chest.85.3.411. [DOI] [PubMed] [Google Scholar]
  20. Shetty P. S., Watrasiewicz K. E., Jung R. T., James W. P. Rapid-turnover transport proteins: an index of subclinical protein-energy malnutrition. Lancet. 1979 Aug 4;2(8136):230–232. doi: 10.1016/s0140-6736(79)90241-1. [DOI] [PubMed] [Google Scholar]
  21. Stein T. P., Buzby G. P. Protein metabolism in surgical patients. Surg Clin North Am. 1981 Jun;61(3):519–527. doi: 10.1016/s0039-6109(16)42434-5. [DOI] [PubMed] [Google Scholar]
  22. Superina R., Meakins J. L. Delayed hypersensitivity, anergy, and the surgical patient. J Surg Res. 1984 Aug;37(2):151–174. doi: 10.1016/0022-4804(84)90176-8. [DOI] [PubMed] [Google Scholar]
  23. Wilson D. O., Rogers R. M., Hoffman R. M. Nutrition and chronic lung disease. Am Rev Respir Dis. 1985 Dec;132(6):1347–1365. doi: 10.1164/arrd.1985.132.6.1347. [DOI] [PubMed] [Google Scholar]
  24. Windsor J. A., Knight G. S., Hill G. L. Wound healing response in surgical patients: recent food intake is more important than nutritional status. Br J Surg. 1988 Feb;75(2):135–137. doi: 10.1002/bjs.1800750215. [DOI] [PubMed] [Google Scholar]
  25. Young G. A., Hill G. L. Assessment of protein-calorie malnutrition in surgical patients from plasma proteins and anthropometric measurements. Am J Clin Nutr. 1978 Mar;31(3):429–435. doi: 10.1093/ajcn/31.3.429. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES