A multinational observational study of clinical nutrition practice in patients undergoing major gastrointestinal surgery: The Nutrition Insights Day

Clin Nutr ESPEN. 2021 Feb:41:254-260. doi: 10.1016/j.clnesp.2020.11.029. Epub 2020 Dec 22.

Abstract

Background and aims: Patients undergoing major gastrointestinal (GI) surgery, particularly those with malignancies, have a high risk for malnutrition, requiring perioperative nutritional support to reduce complications. During the Nutrition Insights Day (NID), nutritional data of this patient population were documented in seven Asian countries.

Methods: Observational, cross-sectional study with retrospective data collection of nutritional status, calorie/protein targets/intake, and type of clinical nutrition for up to 5 days before NID.

Inclusion criteria: Adult patients following major GI surgery, pre-existing/at (high) risk for malnutrition, on enteral (EN) and/or parenteral nutrition (PN) and latest surgery within 10 days before the NID.

Exclusion criteria: Burns, mechanical ventilation on NID, oral nutrition and/or oral nutritional supplements (ONS) on the day before the NID, and emergency procedures.

Results: 536 patients from 83 hospitals, mean age 58.8 ± 15.1 years, 59.1% males, were eligible. Leading diagnosis were GI diseases (48.7%) and GI cancer (45.9%). Malnutrition risk was moderate to high in 54% of patients, low in 46%. Hospital length of stay (LOS) before the NID was 9.3 ± 19.0 days, and time since last surgery 3.7 ± 2.4 days. Lowest caloric/protein deficits were observed in patients receiving EN + PN, followed by PN alone and EN alone. Type of clinical nutrition, Body Mass Index and LOS on surgical intensive care unit (SICU) and/or surgical ward were independent predictors of caloric and of protein deficit.

Conclusion: There is a high prevalence of postoperative nutritional deficits in Asian GI surgery patients, who are either preoperatively malnourished or at risk of malnutrition, indicating a need to improve nutritional support and education.

Keywords: Asia; Caloric deficit; Clinical nutrition; Observational study; Perioperative nutrition; Protein deficit.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Digestive System Surgical Procedures*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status*
  • Parenteral Nutrition
  • Retrospective Studies