Preoperative immunonutrition and its effect on postoperative outcomes in well-nourished and malnourished gastrointestinal surgery patients: a randomised controlled trial

Barker, L. A., Gray, C., Wilson, L., Thomson, B. N. J., Shedda, S. and Crowe, T. C. 2013, Preoperative immunonutrition and its effect on postoperative outcomes in well-nourished and malnourished gastrointestinal surgery patients: a randomised controlled trial, European journal of clinical nutrition, vol. 67, pp. 802-807.

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Title Preoperative immunonutrition and its effect on postoperative outcomes in well-nourished and malnourished gastrointestinal surgery patients: a randomised controlled trial
Author(s) Barker, L. A.
Gray, C.
Wilson, L.
Thomson, B. N. J.
Shedda, S.
Crowe, T. C.
Journal name European journal of clinical nutrition
Volume number 67
Start page 802
End page 807
Total pages 6
Publisher Nature Publishing Group
Place of publication London, England
Publication date 2013
ISSN 0954-3007
Keyword(s) gastrointestinal surgery
malnutrition
length of stay
immunonutrition
cost
Summary Background/Objectives:
Invasive procedures such as surgery cause immunosuppression, leading to increased risk of complications, infections and extended hospital stay. Emerging research around immune-enhancing nutrition supplements and their ability to reduce postoperative complications and reduce treatment costs is promising. This randomised controlled trial aims to examine the effect of preoperative immunonutrition supplementation on length of hospital stay (LOS), complications and treatment costs in both well-nourished and malnourished gastrointestinal surgery patients.

Subjects/Methods:
Ninety-five patients undergoing elective upper and lower gastrointestinal surgery were recruited. The treatment group (n=46) received a commercial immuno-enhancing supplement 5 days preoperatively. The control group (n=49) received no supplements. The primary outcome measure was LOS, and secondary outcome measures included complications and cost.

Results:
A nonsignificant trend towards a shorter LOS within the treatment group was observed (7.1±4.1 compared with 8.8±6.5 days; P=0.11). For malnourished patients, this trend was greater with hospital stay reduced by 4 days (8.3±3.5 vs 12.3±9.5 days; P=0.21). Complications and unplanned intensive care admission rates were very low in both the groups. The average admission cost was reduced by AUD1576 in the treatment group compared with the control group (P=0.37).

Conclusions:
Preoperative immunonutrition therapy in gastrointestinal surgery has the potential to reduce the LOS and cost, with greater treatment benefit seen in malnourished patients; however, there is a need for additional research with greater patient numbers.
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 ©2013, Nature Publishing Group
Persistent URL http://hdl.handle.net/10536/DRO/DU:30057086

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