Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer

Garth, A. K., Newsome, C. M., Simmance, N. and Crowe, T. C. 2010, Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer, Journal of human nutrition and dietetics, vol. 23, no. 4, pp. 393-401.

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Title Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer
Author(s) Garth, A. K.
Newsome, C. M.
Simmance, N.
Crowe, T. C.
Journal name Journal of human nutrition and dietetics
Volume number 23
Issue number 4
Start page 393
End page 401
Total pages 8
Publisher Wiley-Blackwell Publishing Ltd
Place of publication Oxford, England
Publication date 2010
ISSN 0952-3871
1365-277X
Keyword(s) complications
gastrointestinal cancer
length of stay
malnutrition
nutritional assessment
surgery
Summary Background: Malnutrition and its associated complications are a considerable issue for surgical patients with upper gastrointestinal and colorectal cancer.The present study aimed to determine whether specific perioperative nutritional practices and protocols are associated with improved patient outcomes in this group.
Methods: Patients admitted for elective upper gastrointestinal or colorectal cancer surgery (n = 95) over a 19-month period underwent a medical history audit assessing weight changes, nutritional intake, biochemistry, post-operative complications and length of stay. A subset of patients (n = 25) underwent nutritional assessment by subjective global assessment prior to surgery in addition to assessment of post-operative medical outcomes, nutritional intake and timing of dietetic intervention.
Results: Mean (SD) length of stay for patients was 14.0 (12.2) days, with complication rates at 35%. Length of stay was significantly longer in patients who experienced significant preoperative weight loss compared to those who did not [17.0 (15.8) days versus 10.0 (6.8) days, respectively; P < 0.05]. Low albumin and post-operative weight loss were also predictive of increased length of stay. Of patients who underwent nutritional assessment, 32% were classified as mild–moderately malnourished and 16% severely malnourished. Malnourished patients were hospitalised twice as long as well-nourished patients [15.8 (12.8) days versus 7.6 (3.5) days; P < 0.05]. Time taken [6.9 (3.6) days] to achieve adequate nutrition post surgery was a factor in post-operative outcomes, with a positive correlation with length of stay (r = 0.493; P < 0.01), a negative correlation with post-operative weight change (r = —0.417; P < 0.05) and a greater risk of complications (52% versus 13%; P < 0.01).
Conclusions: Malnutrition is prevalent among surgical patients with gastrointestinal cancer. Poor nutritional status coupled with delayed and inadequate post-operative nutrition practices are associated with worse clinical outcomes.
Language eng
Field of Research 111101 Clinical and Sports Nutrition
Socio Economic Objective 920105 Digestive System Disorders
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2010, The Authors & The British Dietetic Association Ltd.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30032570

Document type: Journal Article
Collection: School of Exercise and Nutrition Sciences
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