Impact of the implementation of a preoperative nutritional program for colorectal surgery patients

Rev Esp Enferm Dig. 2020 Dec;112(12):909-914. doi: 10.17235/reed.2020.6572/2019.

Abstract

Introduction: generalized hypermetabolism is common in cancer patients and increases the risk of complications when combined with the systemic effects of surgery.

Objective: the aim of this study was to clinically assess the implementation of a Nutritional Assessment and Support Program for patients undergoing colorectal surgery with a diagnosed neoplasia.

Material and methods: a quasi-experimental study was performed with analyses before and after the implementation of the Nutritional Assessment and Support Program. Patients who underwent surgery for colon or rectal neoplasia were included. The incidence of complications and the average hospital stay were studied. The effect of the intervention was evaluated using a logistic regression analysis to yield adjusted odds ratios (OR).

Results: a total of 130 patients were included in the study, 65 from 2016-2017 (pre-program) and 65 in 2018 (post-program). The incidence of surgical site infection decreased from 18.5 % to 6.2 % (OR = 0.29; 95 % CI: 0.09-0.95) (p = 0.033). Postoperative fevers were also reduced by 50 % (OR = 0.41; 95 % CI: 0.17-0.96) (p = 0.037). Average hospital stay was reduced from 11.3 days (DE = 8) to 7.18 days (DE = 2.5) (p = 0.02). More clinical and analytical information was logged about the patients' nutritional status and risk.

Conclusion: the implementation of a Nutritional Assessment and Support Program for patients undergoing colorectal surgery has shown statistically significant differences in the reduction of surgical site infection, postoperative fever and the length of hospital stay.

MeSH terms

  • Colon
  • Colorectal Surgery*
  • Digestive System Surgical Procedures*
  • Humans
  • Length of Stay
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Surgical Wound Infection