Nutritional Risk Screening 2002 as a Predictor of Postoperative Outcomes in Patients Undergoing Abdominal Surgery: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

<div><p>Background</p><p>The nutritional risk screening (NRS 2002) has been applied increasingly in patients who underwent abdominal surgery for nutritional risk assessment. However, the usefulness of the NRS 2002 for predicting is controversial. This meta-analysis was to examine whether a preoperative evaluation of nutritional risk by NRS 2002 provided prediction of postoperative outcomes in patients undergoing abdominal surgery.</p><p>Methods</p><p>A systematic literature search for published papers was conducted using the following online databases: MEDLINE, EMBASE, the Cochrane library, EBSCO, CRD databases, Cinahl, PsycInfo and BIOSIS previews. The pooled odds ratio (OR) or weight mean difference (WMD) was calculated using a random-effect model or a fix-effect model.</p><p>Results</p><p>Eleven studies with a total of 3527 patients included in this study. Postoperative overall complications were more frequent in nutritional risk patients versus patients without nutritional risk (the pooled OR 3.13 [2.51, 3.90] p<0.00001). The pooled OR of mortality for the nutritional risk group and non-nutritional risk group was 3.61 [1.38, 9.47] (p = 0.009). Furthermore, the postoperative hospital stay was significant longer in the preoperative nutritional risk group than in the nutritional normal group (WMD 5.58 [4.21, 6.95] p<0.00001).</p><p>Conclusions</p><p>The present study has demonstrated that patients at preoperative nutritional risk have increased complication rates, high mortality and prolonged hospital stay after surgery. However, NRS 2002 needs to be validated in larger samples of patients undergoing abdominal surgery by better reference method.</p></div

Forest plot showing the effects of nutritional risk group compared to nutritional normal group on infective complications.

<p>SE, standard error; IV, inverse variance; CI, confidence interval.</p

Forest plot showing the effects of nutritional risk group compared to nutritional normal group on length of hospital stay.

<p>SE, standard error; IV, inverse variance; CI, confidence interval.</p

Patient characteristics of participants in studies included in the meta-analysis.

<p>NA, not available; ASA, American Society of Anesthesiologists; NRI, nutritional risk index; BMI, body mass index; TNM, tumor node metastasis.</p><p>Patient characteristics of participants in studies included in the meta-analysis.</p

Funnel plots for the overall complications in nutritional risk group compared to nutritional normal group.

<p>SE, standard error; OR, odds ratio.</p

Quality assessment of included studies in the meta-analysis.

<p>Quality assessment of included studies in the meta-analysis.</p

Forest plot showing the effects of nutritional risk group compared to nutritional normal group on overall complications.

<p>SE, standard error; IV, inverse variance; CI, confidence interval.</p