{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T17:51:18Z","timestamp":1760982678235,"version":"build-2065373602"},"reference-count":19,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[1984,11,1]],"date-time":"1984-11-01T00:00:00Z","timestamp":468115200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1984,11]]},"abstract":"<jats:p>We used cost\u2010effectiveness analysis to compare three strategies for reducing the incidence of severe nutrition\u2010associated complications (eg, wound dehiscence) in patients undergoing major gastrointestinal surgery: treat all patients with parenteral nutritional support for 10 days before surgery, treat no patients with preoperative parenteral nutritional support, or perform a test which stratifies patients (treating only the \u201chigh risk\u201d or \u201cmalnourished\u201d patients). The \u201ctest\u201d strategy results in the lowest total hospital complication rate when the overall incidence of postoperative nutrition\u2010associated complications is greater than 4% and less than 39%. However, the cost minimizing strategy is \u201ctreat none\u201d as long as the overall incidence is less than 78%. In moving from the \u201ctreat none\u201d to the \u201ctest\u201d strategy, the incremental cost per complication avoided varies from $11,515 (for a 20% overall incidence), to $1,031 (for a 60% overall incidence). These cost\u2010effectiveness ratios for incidence rates above 20% compare favorably to the use of routine screening tests performed on preoperative patients. However, the cost\u2010effectiveness ratios are quite sensitive to the assumptions made concerning the effectiveness of parenteral nutritional support and the predictive properties of the test (derived from previous clinical studies). We conclude that further research is needed to study the overall incidence of severe postoperative nutrition\u2010associated complications for various surgical procedures, to confirm the accuracy of stratification techniques and to confirm previous studies of the effectiveness of preoperative parenteral nutritional support in order to permit third party payers to evaluate the consequences of adopting this intervention as a standard clinical practice. <jats:italic>(Journal of Parenteral and Enternal Nutrition<\/jats:italic> 8:632\u2013637, 1984)<\/jats:p>","DOI":"10.1177\/0148607184008006632","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"632-637","source":"Crossref","is-referenced-by-count":28,"title":["Cost\u2010Effectiveness of Preoperative Parenteral Nutrition in Patients Undergoing Major Gastrointestinal Surgery"],"prefix":"10.1002","volume":"8","author":[{"given":"Allan S.","family":"Detsky","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khursheed N.","family":"Jeejeebhoy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[1984,11]]},"reference":[{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)31639-X"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1974.03240060028025"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1976.03260410023017"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(82)90212-4"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198019250-00004"},{"key":"e_1_2_1_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1982.01380300086019"},{"key":"e_1_2_1_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607184008003245"},{"key":"e_1_2_1_9_1","first-page":"233","article-title":"A comparison of the predictive value of nutritional assessment technique","volume":"36","author":"Baker JP","year":"1982","journal-title":"Hum Nutr Clin Nutr"},{"key":"e_1_2_1_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607184008002153"},{"key":"e_1_2_1_11_1","first-page":"947","article-title":"Interpretation of diagnostic data: 5 How to do it with simple maths","volume":"129","author":"Sackett DL","year":"1983","journal-title":"Can Med Assoc J"},{"volume-title":"Ministry of Health","year":"1981","author":"Hospital Statistics.","key":"e_1_2_1_12_1"},{"key":"e_1_2_1_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0025-7125(16)31632-7"},{"volume-title":"Cholesterol, Children, and Heart Disease: An analysis of alternatives","year":"1980","author":"Berwick DM","key":"e_1_2_1_14_1"},{"key":"e_1_2_1_15_1","doi-asserted-by":"publisher","DOI":"10.4159\/harvard.9780674593541"},{"key":"e_1_2_1_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0038-0121(72)90006-7"},{"volume-title":"Cost\u2010effectiveness analysis for medical practices: appropriate laboratory utilization. In Logic and Economics of Clinical Laboratory Use","year":"1978","author":"Weinstein MC","key":"e_1_2_1_17_1"},{"key":"e_1_2_1_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198005083021904"},{"key":"e_1_2_1_19_1","first-page":"464A","article-title":"Pre\u2010dental antibiotic prophylaxis for mitral valve prolapse: a cost\u2010effectiveness analysis","volume":"31","author":"Clemens JD","year":"1983","journal-title":"Clin Res"},{"key":"e_1_2_1_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197912203012503"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0148607184008006632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T16:56:40Z","timestamp":1760633800000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0148607184008006632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1984,11]]},"references-count":19,"journal-issue":{"issue":"6","published-print":{"date-parts":[[1984,11]]}},"alternative-id":["10.1177\/0148607184008006632"],"URL":"https:\/\/doi.org\/10.1177\/0148607184008006632","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"type":"print","value":"0148-6071"},{"type":"electronic","value":"1941-2444"}],"subject":[],"published":{"date-parts":[[1984,11]]}}}