original article Wien Klin Wochenschr https://doi.org/10.1007/s00508-020-01671-4 Nutritional status and its effect on complications in patients with colorectal cancer Maja Karin · Ante Bogut · Iva Hojsak · Emil Babi ´ c · Mile Volari ´ c · Milenko Bevanda Received: 14 February 2020 / Accepted: 29 April 2020 © Springer-Verlag GmbH Austria, part of Springer Nature 2020 Summary Background Nutritional status is an important factor for predicting the risk of developing complications after a surgical procedure. Many nutritional assess- ments are used in clinical practice, but their role in predicting postoperative outcomes is unknown. Therefore, the aim of this study was to assess the utility of nutritional risk factors at the diagnosis of colorectal cancer (CRC) for predicting early postsur- gical complications. Methods This was a prospective observational study including 127 patients with CRC at diagnosis. Their preoperative nutritional status was analyzed by body mass index (BMI), triceps and subscapular skinfolds and two nutritional scales: the Patient-Generated Subjective Global Assessment (PG-SGA) and the Mal- nutrition Universal Screening Tool (MUST). The out- come variables, including postoperative complica- tions, length of hospital stay and mortality, were analyzed. Results Patients identified as malnourished by PG- SGA score had prolonged hospital stays (p = 0.01). The risk of infection was increased in older patients (hazard ratio, HR 1.12; 95% confidence interval, CI 1.04–1.21) but was not associated with nutritional status. Early wound dehiscence was increased in pa- tients with higher BMI (HR 1.15; 95% CI 1.01–1.29), with higher subscapular skinfold thickness and in- creased age (HR 1.05; 95% CI 1.05–1.10). Postoper- M. Karin () · A. Bogut · E. Babi´ c · M. Volari´ c · M. Bevanda Department of Gastroenterology and Hepatology, University Clinical Hospital Mostar, Bijeli Brijeg bb, Mostar, Bosnia and Herzegovina majakarin78@gmail.com I. Hojsak Referral center for pediatric gastroenetrology and nutrition, Children’s Hospital Zagreb, Klai´ ceva 16, Zagreb, Croatia ative mortality was not significantly associated with nutritional status. Conclusion Malnourished patients, as identified by the PG-SGA score, stayed longer in hospital than pa- tients who were not malnourished, while increased BMI was recognized as a risk factor for wound dehis- cence. Keywords Nutritional assesment · Patient-Generated Subjective Global Assesment · Malnutrition Universal Screening Tool · Length of hospital stay · Postoperative mortality Introduction Colorectal cancer (CRC) is a significant global prob- lem in terms of both the annual incidence, which has been increasing, and the complications that the dis- ease carries. Patients with CRC have various phys- iological and psychological problems, which can ul- timately lead to malnutrition in 29–60% of patients [1–3]. The prevalence of malnutrition in newly diag- nosed patients with CRC depends on the nutritional tools used and the stage of the disease [4]. Malnu- trition is the result of several factors, including the effects of the tumor and its location and stage as well as treatment [5–7]. Malnourished patients have an increased risk for postoperative complications, such as infections and wound dehiscence, which also in- fluence the outcome of the treatment and quality of life [8, 9]. These complications can prolong hospi- talization, increase financial costs and finally reduce the survival rate [10, 11]. According to previous re- search, nearly 20% of patients with cancer die because of malnutrition rather than malignant disease [12]. On the other hand, the impact of obesity or overweight on postoperative complications after gastrointestinal surgery is still a matter of debate. It is well known K Nutritional status and its effect on complications in patients with colorectal cancer