The response to TPN. A form of nutritional assessment

P. M. Starker, Patrick A. LaSala, J. Askanazi, F. E. Gump, R. A. Forse, J. M. Kinney

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Malnutrition in surgical patients is associated with an increased incidence of postoperative mortality and morbidity. Preoperative nutritional support has been shown to be efficacious in reducing the incidence of these complications, although the postoperative complication rate in these patients continues to be greater than in their wellnourished counterparts. This study attempts to determine whether the postoperative course can be either influenced by or predicted from the preoperative response to nutritional support. Twenty-two patients with nutritional depletion who received an average of 1 week of total parenteral nutrition prior to a major abdominal operation were studied. These patients were followed for postoperative complications. Of the 16 patients who exhibited the characteristic response to early nutritional support, diuresis of the expanded extracellular fluid compartment with a resultant loss of weight (127.9 ± 5.7 to 124.6 ± 5.8 (SEM) lbs, p < .001) and rise in serum albumin (3.21 ± 0.14 to 3.46 ± 0.15 gms%, p < 0.001), only one developed a complication in the postoperative period. The other 16 patients did not exhibit this response. They retained additional fluid, gained weight (119.3 ± 8.1 to 121.3 ± 8.2 lbs, p < .025), and showed a decrease in serum albumin levels (3.14 ± 0.14 to 3.00 ± 0.14%), p < 0.01). Eight of these patients developed a total of 15 postoperative complications (p < 0.01). This study demonstrates that the response to preoperative TPN is an important factor in assessing operative risk and morbidity. The need to individualize preoperative support and the timing of surgical intervention is clearly demonstrated.

Original languageEnglish (US)
Pages (from-to)720-724
Number of pages5
JournalAnnals of Surgery
Volume198
Issue number6
StatePublished - 1983
Externally publishedYes

Fingerprint

Nutrition Assessment
Nutritional Support
Serum Albumin
Morbidity
Total Parenteral Nutrition
Diuresis
Incidence
Extracellular Fluid
Postoperative Period
Malnutrition
Weight Loss
Weights and Measures
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Starker, P. M., LaSala, P. A., Askanazi, J., Gump, F. E., Forse, R. A., & Kinney, J. M. (1983). The response to TPN. A form of nutritional assessment. Annals of Surgery, 198(6), 720-724.

The response to TPN. A form of nutritional assessment. / Starker, P. M.; LaSala, Patrick A.; Askanazi, J.; Gump, F. E.; Forse, R. A.; Kinney, J. M.

In: Annals of Surgery, Vol. 198, No. 6, 1983, p. 720-724.

Research output: Contribution to journalArticle

Starker, PM, LaSala, PA, Askanazi, J, Gump, FE, Forse, RA & Kinney, JM 1983, 'The response to TPN. A form of nutritional assessment', Annals of Surgery, vol. 198, no. 6, pp. 720-724.
Starker PM, LaSala PA, Askanazi J, Gump FE, Forse RA, Kinney JM. The response to TPN. A form of nutritional assessment. Annals of Surgery. 1983;198(6):720-724.
Starker, P. M. ; LaSala, Patrick A. ; Askanazi, J. ; Gump, F. E. ; Forse, R. A. ; Kinney, J. M. / The response to TPN. A form of nutritional assessment. In: Annals of Surgery. 1983 ; Vol. 198, No. 6. pp. 720-724.
@article{ac6bd304e28f47a0b1754b0773a56c12,
title = "The response to TPN. A form of nutritional assessment",
abstract = "Malnutrition in surgical patients is associated with an increased incidence of postoperative mortality and morbidity. Preoperative nutritional support has been shown to be efficacious in reducing the incidence of these complications, although the postoperative complication rate in these patients continues to be greater than in their wellnourished counterparts. This study attempts to determine whether the postoperative course can be either influenced by or predicted from the preoperative response to nutritional support. Twenty-two patients with nutritional depletion who received an average of 1 week of total parenteral nutrition prior to a major abdominal operation were studied. These patients were followed for postoperative complications. Of the 16 patients who exhibited the characteristic response to early nutritional support, diuresis of the expanded extracellular fluid compartment with a resultant loss of weight (127.9 ± 5.7 to 124.6 ± 5.8 (SEM) lbs, p < .001) and rise in serum albumin (3.21 ± 0.14 to 3.46 ± 0.15 gms{\%}, p < 0.001), only one developed a complication in the postoperative period. The other 16 patients did not exhibit this response. They retained additional fluid, gained weight (119.3 ± 8.1 to 121.3 ± 8.2 lbs, p < .025), and showed a decrease in serum albumin levels (3.14 ± 0.14 to 3.00 ± 0.14{\%}), p < 0.01). Eight of these patients developed a total of 15 postoperative complications (p < 0.01). This study demonstrates that the response to preoperative TPN is an important factor in assessing operative risk and morbidity. The need to individualize preoperative support and the timing of surgical intervention is clearly demonstrated.",
author = "Starker, {P. M.} and LaSala, {Patrick A.} and J. Askanazi and Gump, {F. E.} and Forse, {R. A.} and Kinney, {J. M.}",
year = "1983",
language = "English (US)",
volume = "198",
pages = "720--724",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - The response to TPN. A form of nutritional assessment

AU - Starker, P. M.

AU - LaSala, Patrick A.

AU - Askanazi, J.

AU - Gump, F. E.

AU - Forse, R. A.

AU - Kinney, J. M.

PY - 1983

Y1 - 1983

N2 - Malnutrition in surgical patients is associated with an increased incidence of postoperative mortality and morbidity. Preoperative nutritional support has been shown to be efficacious in reducing the incidence of these complications, although the postoperative complication rate in these patients continues to be greater than in their wellnourished counterparts. This study attempts to determine whether the postoperative course can be either influenced by or predicted from the preoperative response to nutritional support. Twenty-two patients with nutritional depletion who received an average of 1 week of total parenteral nutrition prior to a major abdominal operation were studied. These patients were followed for postoperative complications. Of the 16 patients who exhibited the characteristic response to early nutritional support, diuresis of the expanded extracellular fluid compartment with a resultant loss of weight (127.9 ± 5.7 to 124.6 ± 5.8 (SEM) lbs, p < .001) and rise in serum albumin (3.21 ± 0.14 to 3.46 ± 0.15 gms%, p < 0.001), only one developed a complication in the postoperative period. The other 16 patients did not exhibit this response. They retained additional fluid, gained weight (119.3 ± 8.1 to 121.3 ± 8.2 lbs, p < .025), and showed a decrease in serum albumin levels (3.14 ± 0.14 to 3.00 ± 0.14%), p < 0.01). Eight of these patients developed a total of 15 postoperative complications (p < 0.01). This study demonstrates that the response to preoperative TPN is an important factor in assessing operative risk and morbidity. The need to individualize preoperative support and the timing of surgical intervention is clearly demonstrated.

AB - Malnutrition in surgical patients is associated with an increased incidence of postoperative mortality and morbidity. Preoperative nutritional support has been shown to be efficacious in reducing the incidence of these complications, although the postoperative complication rate in these patients continues to be greater than in their wellnourished counterparts. This study attempts to determine whether the postoperative course can be either influenced by or predicted from the preoperative response to nutritional support. Twenty-two patients with nutritional depletion who received an average of 1 week of total parenteral nutrition prior to a major abdominal operation were studied. These patients were followed for postoperative complications. Of the 16 patients who exhibited the characteristic response to early nutritional support, diuresis of the expanded extracellular fluid compartment with a resultant loss of weight (127.9 ± 5.7 to 124.6 ± 5.8 (SEM) lbs, p < .001) and rise in serum albumin (3.21 ± 0.14 to 3.46 ± 0.15 gms%, p < 0.001), only one developed a complication in the postoperative period. The other 16 patients did not exhibit this response. They retained additional fluid, gained weight (119.3 ± 8.1 to 121.3 ± 8.2 lbs, p < .025), and showed a decrease in serum albumin levels (3.14 ± 0.14 to 3.00 ± 0.14%), p < 0.01). Eight of these patients developed a total of 15 postoperative complications (p < 0.01). This study demonstrates that the response to preoperative TPN is an important factor in assessing operative risk and morbidity. The need to individualize preoperative support and the timing of surgical intervention is clearly demonstrated.

UR - http://www.scopus.com/inward/record.url?scp=0021068288&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021068288&partnerID=8YFLogxK

M3 - Article

VL - 198

SP - 720

EP - 724

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

IS - 6

ER -