Impact of the nutritional risk score in fast-track colon surgery.
- Hübner M Department of Visceral and Transplantation Surgery, University Hospital Zurich, Zurich, Switzerland. martin.hubner@chuv.ch
- Müller S
- Schäfer M
- Clavien PA
- Demartines N
- 2010-11-06
Published in:
- Digestive surgery. - 2010
Adult
Aged
Aged, 80 and over
Colon
Female
Humans
Length of Stay
Male
Middle Aged
Nutrition Assessment
Nutritional Status
Postoperative Complications
Risk Factors
English
BACKGROUND
Patients at nutritional risk reveal an increased morbidity. Fast-track (FT) programs in colonic surgery have shown reduced complications and hospital stay. We aimed to assess the effect of FT programs on patients at nutritional risk.
METHODS
In a randomized trial (NCT00556790), we compared complications after open colonic surgery with either a FT program or standard care (SC). A subgroup analysis was performed in 67 patients for whom a prospective nutritional risk score (NRS) was available.
RESULTS
The SC and FT groups did not differ regarding patient characteristics or prevalence of NRS ≥ 3 (SC 8/31, FT 7/36, p = 0.569). Patients with SC had more complications (14/31 vs. 8/36, p = 0.044) and a longer hospital stay (9 vs. 5 days, p < 0.0001). No major complication occurred in patients with an NRS <3. Patients at nutritional risk had a high complication rate regardless of SC or FT (6/8 and 5/7, respectively, p = 1.000). Median hospital stay was shorter in FT (7 (range 5-30) days) versus SC patients (14.5 (range 8-30) days, p = 0.164).
CONCLUSIONS
Patients with a NRS ≥ 3 have an increased postoperative morbidity even within a FT program. They should be identified by nutritional screening and might benefit from nutritional supplements.
Patients at nutritional risk reveal an increased morbidity. Fast-track (FT) programs in colonic surgery have shown reduced complications and hospital stay. We aimed to assess the effect of FT programs on patients at nutritional risk.
METHODS
In a randomized trial (NCT00556790), we compared complications after open colonic surgery with either a FT program or standard care (SC). A subgroup analysis was performed in 67 patients for whom a prospective nutritional risk score (NRS) was available.
RESULTS
The SC and FT groups did not differ regarding patient characteristics or prevalence of NRS ≥ 3 (SC 8/31, FT 7/36, p = 0.569). Patients with SC had more complications (14/31 vs. 8/36, p = 0.044) and a longer hospital stay (9 vs. 5 days, p < 0.0001). No major complication occurred in patients with an NRS <3. Patients at nutritional risk had a high complication rate regardless of SC or FT (6/8 and 5/7, respectively, p = 1.000). Median hospital stay was shorter in FT (7 (range 5-30) days) versus SC patients (14.5 (range 8-30) days, p = 0.164).
CONCLUSIONS
Patients with a NRS ≥ 3 have an increased postoperative morbidity even within a FT program. They should be identified by nutritional screening and might benefit from nutritional supplements.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1159/000313692
- PMID 21051894
- Persistent URL
- https://sonar.ch/global/documents/235979
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