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Title: Impact of nutritional status/risk and post-operative nutritional management on clinical outcomes in patients undergoing gastrointestinal surgery: a prospective observational study.
Austin Authors: Narendra, K;Kiss, N;Margerison, C;Johnston, B;Chapman, Brooke 
Affiliation: Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
Department of Nutrition and Dietetics, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Aug-2020
Date: 2020-05-04
Publication information: Journal of Human Nutrition and Dietetics 2020; 33(4):587-597
Abstract: Malnutrition is prevalent in patients undergoing gastrointestinal (GI) surgery and has been linked to adverse outcomes. The present study aimed to determine the association between early post-operative nutritional status/risk, post-operative nutritional management and clinical outcomes. A prospective observational study was conducted in GI surgical patients with a minimum 3-day post-operative length of stay (LOS). Data on patient demographics, nutritional status/risk, post-operative nutritional management and clinical outcomes were collected. Four markers of nutritional status and risk were assessed: preoperative weight loss, nutrition risk, malnutrition status and hand grip strength. Clinical outcomes included: post-operative LOS, complication and readmissions rates. Multivariate linear and logistic regression were used to test for associations with clinical outcomes. One hundred and fifteen patients (55% female) with mean (SD) age of 60.8 (16.2) years were included. Median (IQR) post-operative LOS was 8.0 days (4.5-11.5), 37% of participants developed at least one complication post-operatively and 24% were readmitted within 30-days of discharge. Mean number of nil-by mouth (NBM) days post-operatively was 0.7 (1.2) and the average time to commence feeding was 3.3 (2.2) days after surgery. Poor nutritional status/risk between days 3-5 post-operatively assessed through all four markers was associated with longer post-operative LOS (all P < 0.05). No association was found between number of NBM days, time to feeding and clinical outcomes. Poor early post-operative nutritional status/risk is associated with longer post-operative LOS in patients undergoing GI surgery, which may facilitate simple identification of patients at high priority for nutritional intervention. The present study highlights the heterogeneity in post-operative nutritional management practices.
DOI: 10.1111/jhn.12763
ORCID: 0000-0002-9359-4519
Journal: Journal of Human Nutrition and Dietetics
PubMed URL: 32364298
Type: Journal Article
Subjects: complications
gastrointestinal surgery
hand grip strength
length of stay
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