scholarly journals Malnutrition and Increased Risk of Adverse Outcomes in Elderly Patients Undergoing Elective Colorectal Cancer Surgery: A Case-Control Study Nested in a Cohort

Nutrients ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 207
Author(s):  
Cristina Martínez-Escribano ◽  
Francisco Arteaga Moreno ◽  
Marcos Pérez-López ◽  
Cristina Cunha-Pérez ◽  
Ángel Belenguer-Varea ◽  
...  

Background: Malnutrition increases worse outcomes during hospital admission for elective colorectal cancer (CRC) surgery in older adults. Methods: This work was designed an observational, monocentric, case-control study nested in a cohort of patients undergoing elective surgery for CRC disease at the Hospital Universitario de la Ribera (HULR) (Alzira, Valencia, Spain) between 2011 and 2019. The study considered patients with a CONUT score in the range of moderate to severe malnutrition (>4 points), with control patients with normal nutritional situations or mild malnutrition. Results: Moderate-to-severe malnutrition cases presented a greater length of stay (LOS), a higher incidence of adverse events (both medical and surgical complications), a higher incidence of surgical-wound infection, a greater need for blood transfusion, and a greater amount of transfused packed red blood cells. During hospitalization, the percentage of patients without nutritional risk decreased from 46 to 9%, and an increase in mild, moderate, and severe risk was observed. Patients with severe nutritional risk at hospital admission had significantly increased mortality at 365 days after discharge (HR: 2.96 (95% CI 1.14–7.70, p = 0.002)). After adjusting for sex, age, and Charlson index score, patients with severe nutritional risk at admission maintained a higher mortality risk (HR: 3.08 (95% CI 1.10–8.63, p = 0.032)). Conclusion: Malnutrition prevalence is high in older adults undergoing CRC elective surgery. Furthermore, this prevalence increases during hospital admission. Malnutrition is linked to worse outcomes, such as LOS, surgical and clinical complications, and mortality. For this reason, nutritional interventions are very important in the perioperative period

2018 ◽  
Vol 75 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Wa Mwenga Walasa ◽  
Renee N Carey ◽  
Si Si ◽  
Lin Fritschi ◽  
Jane S Heyworth ◽  
...  

ObjectiveResearch indicates that shiftwork may be associated with increased risks of adverse health outcomes, including some cancers. However, the evidence of an association between shiftwork and colorectal cancer risk is limited and inconclusive. Further, while several possible pathways through which shiftwork might result in cancer have been proposed, few studies have taken these factors into account. We investigated the association between two types of shiftwork (graveyard shiftwork and early-morning shiftwork) and six mechanistic shiftwork variables (including light at night and phase shift) and the risk of colorectal cancer among females in an Australian population-based case–control study. Graveyard shiftwork was the primary exposure of interest.MethodsParticipants (350 cases and 410 controls) completed a lifetime occupational history, and exposure to each of the eight shiftwork variables was assigned to participants through a job exposure matrix. We used logistic regression to calculate odds ratios (OR) and corresponding 95% confidence intervals (CI) for the association between different shiftwork variables and the risk of colorectal cancer, adjusting for potential demographic, lifestyle and medical confounders.ResultsWorking in an occupation involving long-term exposure (>7.5 years) to graveyard shiftwork was not associated with colorectal cancer risk (adjusted OR 0.95, 95% CI 0.57 to 1.58). Similarly, no increased risks of colorectal cancer were seen for any of the other seven shiftwork variables examined.ConclusionsNo evidence of an increased risk of colorectal cancer among females who had worked in occupations involving shiftwork was observed in this study.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053511
Author(s):  
Johannes Van der Meer ◽  
Pavlos Mamouris ◽  
Vahid Nassiri ◽  
Bert Vaes ◽  
Marjan van den Akker

ObjectivesTo examine the association between the use of oral antibiotics and subsequent colorectal cancer risk.DesignMatched case–control study.SettingGeneral practice centres participating in the Integrated Computerised Network database in Flanders, Belgium.ParticipantsIn total, 1705 cases of colorectal cancer diagnosed between 01 January 2010 and 31 December 2015 were matched to 6749 controls by age, sex, comorbidity and general practice centre.Primary outcome measureThe association between the number of prescriptions for oral antibiotics and the incidence of colorectal cancer over a period of 1–10 years, estimated by a conditional logistic regression model.ResultsA significantly increased risk of colorectal cancer (OR 1.25, 95% CI 1.10 to 1.44) was found in subjects with one or more prescriptions compared with those with none after correction for diabetes mellitus. No dose-response relationship was found.ConclusionsThis study resulted in a modestly higher risk of having colorectal cancer diagnosed after antibiotic exposure. The main limitation was missing data on known risk factors, in particular smoking behaviour. This study did not allow us to examine the causality of the relationship, indicating the need of further investigation.


2017 ◽  
Vol 30 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Manuel E. Machado-Duque ◽  
Juan Pablo Castaño-Montoya ◽  
Diego A. Medina-Morales ◽  
Alejandro Castro-Rodríguez ◽  
Alexandra González-Montoya ◽  
...  

ABSTRACTBackground:To determine the association between the use of opioids and benzodiazepines and the risk of falls with hip fracture in populations older than 65 years in Colombia.Methods:A case-control study with patients older than 65 years with diagnosis of hip fracture. Two controls were obtained per case. The drugs dispensed in the previous 30 days were identified. Sociodemographic, diagnostic, pharmacological (opioids and benzodiazepines), and polypharmacy variables were analyzed. A logistic regression model was used to analyze the risk of fall with hip fracture while using these drugs.Results:We included 287 patients with hip fractures and 574 controls. There was a female predominance (72.1%) and a mean age of 82.4 ± 8.0 years. Of the patients, 12.7% had been prescribed with opioids and 4.2% with benzodiazepines in the previous month. The adjusted multivariate analysis found that using opioids (OR:4.49; 95%CI:2.72–7.42) and benzodiazepines (OR:3.73; 95%CI:1.60–8.70) in the month prior to the event was significantly associated with a greater probability of suffering a fall with hip fracture.Conclusions:People who are taking opioids and benzodiazepines have increased risk for hip fracture in Colombia. Strategies to educate physicians regarding the pharmacology of older adults should be strengthened.


2014 ◽  
Vol 79 (5) ◽  
pp. AB530
Author(s):  
Estanislao J. GóMez ◽  
Lisandro Pereyra ◽  
Raquel GonzáLez ◽  
Carolina Fischer ◽  
José M. Mella ◽  
...  

2015 ◽  
Vol 114 (1) ◽  
pp. 152-158 ◽  
Author(s):  
Nitin Shivappa ◽  
Antonella Zucchetto ◽  
Maurizio Montella ◽  
Diego Serraino ◽  
Susan E. Steck ◽  
...  

Diet and inflammation have been suggested to be important risk factors for colorectal cancer (CRC). In the present study, we examined the association between the dietary inflammatory index (DII) and the risk of CRC in a multi-centre case–control study conducted between 1992 and 1996 in Italy. The study included 1225 incident colon cancer cases, 728 incident rectal cancer cases and 4154 controls hospitalised for acute non-neoplastic diseases. The DII was computed based on dietary intake assessed using a validated seventy-eight-item FFQ that included assessment of alcohol intake. Logistic regression models were used to estimate the OR adjusted for age, sex, study centre, education, BMI, alcohol drinking, physical activity and family history of CRC. Energy intake was adjusted using the residual method. Subjects with higher DII scores (i.e. with a more pro-inflammatory diet) had a higher risk of CRC, with the DII being used both as a continuous variable (ORcontinuous 1·13, 95 % CI 1·09, 1·18) and as a categorical variable (ORquintile 5 v. 1 1·55, 95 % CI 1·29, 1·85; P for trend < 0·0001). Similar results were observed when the analyses were carried out separately for colon and rectal cancer cases. These results indicate that a pro-inflammatory diet is associated with an increased risk of CRC.


2007 ◽  
Vol 26 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Maren Weischer ◽  
Stig Egil Bojesen ◽  
Anne Tybjærg-Hansen ◽  
Christen Kirk Axelsson ◽  
Børge Grønne Nordestgaard

Purpose CHEK2*1100delC heterozygosity has been associated with increased risk of breast, prostate, and colorectal cancer in case-control studies. We tested the hypothesis that CHEK2*1100delC heterozygosity in the general population increases the risk of cancer in general, and breast, prostate, and colorectal cancer in particular. Patients and Methods We performed a prospective study of 9,231 individuals from the Danish general population, who were observed for 34 years, and we performed a case-control study including 1,101 cases of breast cancer and 4,665 controls. Results Of the general population, 0.5% were heterozygotes and 99.5% were noncarriers. In the prospective study, multifactorially adjusted hazard ratios by CHEK2*1100delC heterozygosity versus noncarriers were 1.2 (95% CI, 0.7 to 2.1) for all cancers, 3.2 (95% CI, 1.0 to 9.9) for breast cancer, 2.3 (95% CI, 0.6 to 9.5) for prostate cancer, and 1.6 (95% CI, 0.4 to 6.5) for colorectal cancer. In the case-control study, age-matched odds ratio for breast cancer by CHEK2*1100delC heterozygosity versus noncarriers was 2.6 (95% CI, 1.3 to 5.4). The absolute 10-year risk of breast cancer in CHEK2*1100delC heterozygotes amounted to 24% in women older than 60 years undergoing hormone replacement therapy, with a body mass index of 25 kg/m2 or higher. Conclusion CHEK2*1100delC heterozygosity is associated with a three-fold risk of breast cancer in women in the general population.


2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0045
Author(s):  
Roberto Zambelli ◽  
Banne Nemeth ◽  
Carolina Touw ◽  
Suely Rezende ◽  
Suzanne Cannegieter

Category: Complications Introduction/Purpose: Venous thromboembolism (VTE) is the leading cause of preventable hospital death. There are several risk factors for VTE of which orthopedic surgery is an important one. VTE risk is highest following major orthopedic surgery and therefore some form of prophylactic therapy is usually recommended here. In contrast, the risk for VTE following foot and ankle surgery is less clear and so are guidelines on VTE prophylaxis in these patients. The purpose is to estimate the risk of VTE and the duration of the increased risk period after foot and ankle surgery. Methods: Data from a large population-based case–control study (the Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis [MEGA] study) on the etiology of venous thrombosis were used (5129 cases; 5882 controls). Odds ratios (ORs) with 95% confidence intervals (CIs), adjusted for age, sex and body mass index (ORadj) were calculated for patients undergoing any foot or ankle intervention before the index date (VTE date or control date). Results: 286 cases and 96 controls underwent any orthopedic intervention in the year before the index date for an ORadj of 3.7 (95%CI 2.9-4.8) The ORadj in the first 90-days was 11.4 (95%CI 7.3-17.7). 57 cases and 20 controls had a foot or ankle intervention in the year before the index date, resulting in a three-fold increased risk for VTE (OR 3.3, 95% CI 1,9-5.5). VTE risk was highest in the first 30 (ORadj 10.2,95%CI 3.0-33.9) and 90-days following surgery (ORadj 12.4, 95% CI 4.4-34.8). In 34 patients the surgery was trauma related while 43 patients underwent elective surgery. Traumatic surgery was associated with a higher risk compared with elective surgery for an OR of 13.9 (95%CI 1.8-108.4) and 8.3 (95%CI 1.9-36.9), respectively at 30-days. Conclusion: Foot and ankle procedures were associated with an increased VTE risk which was highest in the first 90-days following surgery. Trauma related surgery was associated with a higher VTE risk than elective surgery. These results are important to decide on thromboprophylactic measures following foot and ankle surgery.


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