Xiaomei Zheng, Mei En Joy Yeo, Charles Chin Han Lew
{"title":"The association between pre-operative malnutrition and post-amputation clinical outcomes: A systematic review","authors":"Xiaomei Zheng, Mei En Joy Yeo, Charles Chin Han Lew","doi":"10.1177/20101058221094864","DOIUrl":null,"url":null,"abstract":"Background: In patients who underwent lower limb amputation (LLA), the prevalence of malnutrition and its association with clinical outcomes are unclear. Objectives: This systematic review aims to identify literature and summarise existing information on (1) the prevalence of malnutrition in the patients with LLA and (2) the association between pre-operative nutritional status and post-surgery clinical outcomes in patients who require amputation. Methods: A search was conducted in four electronic databases (Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL and Scopus) to identify eligible studies. The search strategy was based on keywords – amputation, malnutrition and undernutrition. Article were included regardless of the study design; and if they were written in English; included adult patients with lower limb or foot amputation; and performed pre-amputation nutrition assessments. Results: Seven articles met the eligibility criteria. Malnutrition was assessed by biochemistry and/or anthropometry – none of which are validated nutrition assessment tools. Nevertheless, abnormal biochemistry and/or anthropometry results were associated with delayed wound healing, complications and failed amputation compared to normal ranges. The association between abnormal biochemistry and/or anthropometry parameters and mortality was less consistent. Only one study used a validated nutrition screen tool and found half of the population with LLA were at risk of malnutrition, but no association was reported. Conclusions: The association between malnutrition and clinical outcomes in patients who underwent LLA remains unclear as all the eligible studies that investigated association used unvalidated nutrition assessment tools. There is an urgent need to address this knowledge gap in future research.","PeriodicalId":44685,"journal":{"name":"Proceedings of Singapore Healthcare","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Proceedings of Singapore Healthcare","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/20101058221094864","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 1
Abstract
Background: In patients who underwent lower limb amputation (LLA), the prevalence of malnutrition and its association with clinical outcomes are unclear. Objectives: This systematic review aims to identify literature and summarise existing information on (1) the prevalence of malnutrition in the patients with LLA and (2) the association between pre-operative nutritional status and post-surgery clinical outcomes in patients who require amputation. Methods: A search was conducted in four electronic databases (Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, CINAHL and Scopus) to identify eligible studies. The search strategy was based on keywords – amputation, malnutrition and undernutrition. Article were included regardless of the study design; and if they were written in English; included adult patients with lower limb or foot amputation; and performed pre-amputation nutrition assessments. Results: Seven articles met the eligibility criteria. Malnutrition was assessed by biochemistry and/or anthropometry – none of which are validated nutrition assessment tools. Nevertheless, abnormal biochemistry and/or anthropometry results were associated with delayed wound healing, complications and failed amputation compared to normal ranges. The association between abnormal biochemistry and/or anthropometry parameters and mortality was less consistent. Only one study used a validated nutrition screen tool and found half of the population with LLA were at risk of malnutrition, but no association was reported. Conclusions: The association between malnutrition and clinical outcomes in patients who underwent LLA remains unclear as all the eligible studies that investigated association used unvalidated nutrition assessment tools. There is an urgent need to address this knowledge gap in future research.
背景:在接受下肢截肢(LLA)的患者中,营养不良的患病率及其与临床结果的关系尚不清楚。目的:本系统综述旨在确定文献并总结现有信息:(1)LLA患者营养不良的患病率;(2)需要截肢的患者术前营养状况与术后临床结果之间的关系。方法:在四个电子数据库(Cochrane Central Register of Controlled Trials(Central)、PubMed、CINAHL和Scopus)中进行搜索,以确定符合条件的研究。搜索策略基于关键词——截肢、营养不良和营养不良。无论研究设计如何,均包括文章;如果它们是用英语写的;包括下肢或足部截肢的成年患者;并进行截肢前营养评估。结果:7篇文章符合资格标准。营养不良通过生物化学和/或人体测量法进行评估——这些都不是经过验证的营养评估工具。然而,与正常范围相比,异常的生物化学和/或人体测量结果与伤口愈合延迟、并发症和截肢失败有关。异常生物化学和/或人体测量参数与死亡率之间的相关性不太一致。只有一项研究使用了经过验证的营养筛查工具,发现半数LLA患者有营养不良的风险,但没有相关报告。结论:LLA患者的营养不良与临床结果之间的相关性尚不清楚,因为所有调查相关性的合格研究都使用了未经验证的营养评估工具。在未来的研究中,迫切需要解决这一知识差距。