Impacto da provável sarcopenia e da desnutrição na readmissão não programada em 30 dias em pacientes oncológicos submetidos a operação de grande porte

Abstract

Several factors contribute to the increase in the postoperative readmission rate. Among them, complications and damage to the skeletal muscles stand out. Objective: to evaluate the 30-day unscheduled readmission rate and the association with sarcopenia and malnutrition in cancer patients undergoing major surgery. Method: Prospective, bicentric observational study carried out with adult cancer patients undergoing major surgery. The main variable was the frequency of unscheduled readmission at 30 days postoperatively and the association with probable sarcopenia and malnutrition. Patients classified, according to the subjective global assessment, as B and C were considered malnourished. Patients with a score ≥4 on the SARC-F questionnaire (Strength, Assistance with walking, Rise from a chair, Climb stairs - and Falls), and with low strength hand grip (<27 and <16 kgf) were diagnosed with probable sarcopenia. Results: 238 patients with a median age of 60 years were studied, being 51.7% female. The readmission rate corresponded to 8.4% (n=20) of the cases. Univariate analysis showed an association between malnutrition (OR=4.84; p=0.024) and probable sarcopenia (OR=4.94; p=0.049) with readmission. Furthermore, when both conditions were present, the patient was almost 9 times more likely to be readmitted (OR=8.9; p=0.017). According to the multivariate analysis, only patients diagnosed at the same time with probable sarcopenia and malnutrition had a greater chance of unscheduled readmission (OR=8.1; p=0.032) at 30 days postoperatively. Conclusion: the readmission rate was 8.4% and the presence, at the same time, of probable sarcopenia and malnutrition proved to be an independent risk factor for unscheduled readmission within 30 days of the operation.