A study on impact of perioperative nutrition support in surgical gastroenterology patients in era of eras
Author(s): Dr. Md. Akheeluddin Khaja and Dr. Amar Chand
Abstract:Background: Preoperative malnutrition is common in surgical patients and has been associated with poor clinical outcomes.
Aim and Objective: This study is undertaken to assess the role of perioperative nutrition on mortality and morbidity in surgical patients who are moderately and severely undernourished in Indian patients.
Methodology: Prospective randomized control study, approved from budget committee and research methology and ethical committee of Nizam Institute of Medical Science was taken prior to the study. The patients will be interview within 24 hours of admission for information on nutritional status and disease severity according to the items in NRS -2002, the total NRS score is 0-7,with NRS >3 means no nutritional risk. All patients in nutrition intervention group in both moderately nourished and severely nourished group will receive enteral nutrition 7 days before surgery.
Results: A total of 1315 consecutive patients admitted in department of surgical gastroenterology ward from January 2014 to July 2015 in Nizam institute of medical science are evaluated in the study for the nutrition status assessment.100 patients of severely malnourished and moderately malnourished patients were included in the study. Mean age of all the groups were 44.61-+13.5. NRS scores of moderately patients are with nutrition are 72% patients are score 3 and in moderately malnourished patients the NRS score of 56% are 3. Only one patient in the moderately malnourished patients received combined nutrition and 24 % of severely malnourished patients received either parenteral only or combined nutrition. Prealbumin levels are higher in moderately malnourished >15 mg/dl about 68% in moderately malnourished without nutrition and 72% in moderately malnourished with nutrition Prealbumin levels are in lower level in severly malnourished with >15 mg/dl in 52% on severely malnourished without patients and 44% in severely malnourished with nutrition in 44%. The blood loss is higher in the moderately malnourished group without nutrition but when compared between the groups of moderately nourished there is no significant difference in the blood loss.
Conclusion: The present study does not favour the preoperative nutrition support in moderately malnourished group with NRS score 3 or 4 as there is no difference in the mortality and the morbidity and LOS.