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Malnutrition is common in patients with lung cancer. In patients with malnutrition risk, the risk of complications is high both in the perioperative, early and late postoperative periods. Malnutrition is an independent risk factor for length of hospital stay and cost in these patients. Patients with lung cancer may have many morbidities in postoperative period, especially problems with wound healing. Therefore, assessment of the nutritional status of patients with lung cancer should begin at the diagnosis stage.
In patients with lung cancer scheduled for lobectomy, anthropometric measurements will be measured and the results of laboratory tests(albumin, prealbumin, creatinine, total lymphocyte count, C reactive protein), Nutritional Risk Screening-2002, Nutritional Risk Index, Mini Nutritional Assessment, Glasgow Prognostic Score, Prognostic Nutritional Index and neoadjuvant chemotherapy or not will be recorded in 72 hours before surgery. In addition, demographic information of the patients (name, surname, identification number, age, comorbidity, American Society of Anesthesiologists score) will be recorded. After the information is given to the patients, their written and verbal consent will be obtained.
In the operating room, routine monitoring (electrocardiography, invasive blood pressure measurement, arterial blood gas monitoring, peripheral oxygen saturation, end-tidal carbon dioxide measurement by capnography) will be applied to the patients in accordance with the standard protocol for elective lobectomy surgery.
Hemodynamic changes (eg. dysrhythmia, hypotension, hypertension, hemorrhage), metabolic status (pH, bicarbonate, base excess), lactate, glucose level in blood gas evaluation and intraoperative complications will be recorded during the intraoperative period.
In the postoperative period, length of stay in the intensive care unit, length of hospital stay, early complications (eg. dysrhythmia, acute coronary syndrome, sepsis, mediastinitis, pneumonia, surgical site infection, prolonged air leak), time to start oral intake and transition to adequate oral intake will be recorded in the one-month postoperative period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lung cancer scheduled lobectomy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nutritional Risk Screening-2002 | Diagnostic Test | Nutritional Risk Screening-2002 |
|
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative complications | dysrhythmia, acute coronary syndrome, sepsis, mediastinitis, pneumonia, surgical site infection, prolonged air leak | a month after the surgery |
| Length of stay in the intensive care unit | Length of stay in the intensive care unit | up to 30 days |
| Length of hospital stay | Length of hospital stay | up to 30 days |
| Intraoperative hemodynamic complications | dysrhythmia, hypotension, hypertension, hemorrhage | during the procedure |
| Measure | Description | Time Frame |
|---|---|---|
| Oral intake | time to start oral intake and transition to adequate oral intake | up to 30 days |
| pH | pH in arterial blood gas evaluation |
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Inclusion Criteria:
Exclusion Criteria:
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18 years and older patients who underwent lobectomy with a diagnosis lung cancer
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Seda Eğilmez | Contact | 905063564052 | egilmezseda@gmail.com | |
| Nermin Kelebek Girgin | Contact | 905323875956 | nerminkelebek@yahoo.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bursa Uludağ Üniversitesi Tıp Fakültesi | Recruiting | Bursa | Nilüfer | 16000 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 27642056 | Background | Cederholm T, Barazzoni R, Austin P, Ballmer P, Biolo G, Bischoff SC, Compher C, Correia I, Higashiguchi T, Holst M, Jensen GL, Malone A, Muscaritoli M, Nyulasi I, Pirlich M, Rothenberg E, Schindler K, Schneider SM, de van der Schueren MA, Sieber C, Valentini L, Yu JC, Van Gossum A, Singer P. ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr. 2017 Feb;36(1):49-64. doi: 10.1016/j.clnu.2016.09.004. Epub 2016 Sep 14. | |
| 32113029 |
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| Nutritional Risk Index | Diagnostic Test | Nutritional Risk Index |
|
| Mini Nutritional Assessment | Diagnostic Test | Mini Nutritional Assessment |
|
| Glasgow Prognostic Score | Diagnostic Test | Glasgow Prognostic Score |
|
| Prognostic Nutritional Index | Diagnostic Test | Prognostic Nutritional Index |
|
| Anthropometric measurements | Diagnostic Test | middle arm circumference |
|
| Handgrip strength test | Device | Handgrip strength test |
|
| during the procedure |
| bicarbonate | bicarbonate level in arterial blood gas evaluation | during the procedure |
| base excess | base excess in arterial blood gas evaluation | during the procedure |
| lactate | lactate level in arterial blood gas evaluation | during the procedure |
| glucose | glucose level in arterial blood gas evaluation | during the procedure |
| Background |
| McKenna NP, Bews KA, Al-Refaie WB, Colibaseanu DT, Pemberton JH, Cima RR, Habermann EB. Assessing Malnutrition Before Major Oncologic Surgery: One Size Does Not Fit All. J Am Coll Surg. 2020 Apr;230(4):451-460. doi: 10.1016/j.jamcollsurg.2019.12.034. Epub 2020 Feb 26. |
| 3820522 | Background | Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, Jeejeebhoy KN. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr. 1987 Jan-Feb;11(1):8-13. doi: 10.1177/014860718701100108. |
| 12765673 | Background | Kondrup J, Rasmussen HH, Hamberg O, Stanga Z; Ad Hoc ESPEN Working Group. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003 Jun;22(3):321-36. doi: 10.1016/s0261-5614(02)00214-5. |
| 9990575 | Background | Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum D, Lauque S, Albarede JL. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition. 1999 Feb;15(2):116-22. doi: 10.1016/s0899-9007(98)00171-3. |
| 18395946 | Background | Neelemaat F, Kruizenga HM, de Vet HC, Seidell JC, Butterman M, van Bokhorst-de van der Schueren MA. Screening malnutrition in hospital outpatients. Can the SNAQ malnutrition screening tool also be applied to this population? Clin Nutr. 2008 Jun;27(3):439-46. doi: 10.1016/j.clnu.2008.02.002. Epub 2008 Apr 18. |
| ID | Term |
|---|---|
| D008175 | Lung Neoplasms |
| D044342 | Malnutrition |
| ID | Term |
|---|---|
| D012142 | Respiratory Tract Neoplasms |
| D013899 | Thoracic Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
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