#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#
CS
proLékaře.cz / Journals / Perspectives in Surgery / 2023 - 7

Preoperative nutritional management – compliance with current guidelines

Czech version

Authors: R. Slováček;  Z. Adamová
Authors‘ workplace: Chirurgické oddělení Vsetínské nemocnice, a. s., Vsetín, Česká republika
Published in: Rozhl. Chir., 2023, roč. 102, č. 7, s. 298-303.
Category: Original articles
doi: https://doi.org/10.33699/PIS.2023.102.7.298–303

Overview

Introduction: Major surgery poses a significant stress to the patient. The nutritional status is one of crucial factors that have a substantial impact on the final outcome of the surgery. Preoperatively established malnutrition or an increased nutritional risk in this group of patients requires a maximum effort to minimize this negative impact as soon as the operation is scheduled. The aim of this retrospective study was to assess compliance with guidelines focused on preoperative nutrition management at our site.

Methods: Our retrospective descriptive observation was focused on the period from January 1, 2017 to June 30, 2020. All patients scheduled for major surgery were screened for nutritional status using a nutritional questionnaire, and an appropriate type of nutritional intervention was indicated based on the achieved score.

Results: Two hundred and forty gastrointestinal operations were performed during the study period. In total, 208 (87%) of patients were screened at the time of counselling. Diet adjustments with an increased protein intake were recommended to all 125 (100%) patients with normal nutrition status. In total, 95 patients were at nutritional risk and sipping was prescribed to all of them (100%) in the outpatient setting. All 20 malnourished patients (100%) underwent preoperative nutritional optimization as inpatients.

Conclusion: Nutritional status of patients before major surgery is considered a predictive indicator of potential postoperative complications. Compliance with recent ERAS guidelines concerning preoperative screening and nutritional support is high in our department.

Keywords:

surgical patient – nutritional screening – preoperative period – nutritional therapy

Sources
  1. Zadák Z. Výživa v intenzivní péči. 2. vydání, Praha, Grada 2008.
  2. Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS®) Society recommendations: 2018. World J Surg. 2019  Mar;43(3):659–695.  doi:10.1007/s00268-018-4844-y. PMID: 30426190.
  3. Satinský I, Havel E, Bezděk K, et al. Klinická výživa v chirurgii – doporučení ESPEN s konsenzuálním hlasováním pracovní skupiny SKVIMP. Klinický doporučený postup. Rozhl Chir. 2018;97:1–9.
  4. Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery. Clin Nutr. 2017;36:623−650. doi:10.1016/j.clnu.2017.02.013.02615614/ © 2017.
  5. Gustafsson UO, Hausel J, Thorell A, et al. Adherence to the enhanced recovery after surgery protocol and outcomes after colorectal cancer surgery. Arch Surg. 2011;146:571–577. doi:10.1001/archsurg.2010.309.
  6. Ryska O, Šerclová Z, Antoš F. Jak jsou dodržovány postupy moderní perioperační péče (enhanced recovery after surgery) na chirurgických pracovištích v ČR – výsledky národní ankety. Rozhl Chir 2013;92:435–432.
  7. Vymazal T, Kocián P, Přikryl P. ERAS v české nemocnici – utopie, nebo realita? Anest Intenziv Med. 2018;29:317–321.
  8. Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr. 2003;22(3):321–336. doi: 10.1016/s0261-5614(02)00214-5.
  9. Studley HO. Percentage of weight loss: a basic indicator of surgical risk in patients with chronic peptic ulcer. JAMA 1936:458–460.
  10. van Bokhorst-de van der Schueren MA, van Leeuwen PA, Sauerwein HP, et al. Assessment of malnutrition parameters in head and neck cancer and their relation to postoperative complications. Head Neck 1997;19(5):419–425. doi:10.1002/ (sici)1097-0347(199708)19:5<419:aid--hed9>3.0.co;2-2.
  11. Durkin MT, Mercer KG, McNulty MF, et al. Vascular surgical society of great britain and ireland: contribution of malnutrition to postoperative morbidity in vascular surgical patients. Br J Surg. 1999;86(5):702. doi:10.1046/j.1365-2168.1999.0702a.x.
  12. Pikul J, Sharpe MD, Lowndes R, et al. Degree of preoperative malnutrition is predictive of postoperative morbidity and mortality in liver transplant recipients. Transplantation 1994;57(3):469–472. doi:10.1097/00007890-19940215000030.
  13. Available at: https://www.who.int/health-topics/malnutrition#tab=tab_1.
  14. Cederholm T, Bosaeus I, Barazzoni R, et al. Diagnostic criteria for malnutrition – An ESPEN consensus statement. Clin Nutr. 2015;34(3):335–340. doi:10.1016/j.clnu.2015.03.001.
  15. Soeters PB, Schols AM. Advances in understanding and assessing malnutrition. Curr Opin Clin Nutr Metab Care 2009;12(5):487–494.  doi:10.1097/MCO.0b013e32832da243.
  16. Sorensen J, Kondrup J, Prokopowicz J, et al. EuroOOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. EuroOOPS study group. Clin Nutr. 2008;27(3):340–349. doi:10.1016/j. clnu.2008.03.012.
  17. Schwegler I, von Holzen A, Gutzwiller J-P, et al. Nutritional risk is a clinical predictor of postoperative mortality and morbidity in surgery for colorectal cancer. Br J Surg. 2010,97(1):92–97. doi:10.1002/bjs.6805.
  18. Kuppinger D, Hartl WH, Bertok M, et al. Nutritional screening for risk prediction in patients scheduled for abdominal operations. Br J Surg. 2012;99(5):728–737. doi:10.1002/bjs.8710.
  19. van Stijn MF, Korkic-Halilovic I, Bakker MS, et al. Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review. J Parenter Enteral Nutr. 2013;37(1):37–43. doi:10.1177/0148607112445900.
  20. Skoblej T, Schwarz P, Satinský I. Nové ambulantní možnosti ovlivnění malnutrice chirurgem. Rozh Chir. 2021;100(2):60–65. doi:10.33699/PIS.2021.100.2.6065.
  21. Kaška M, Grosmanová T, Havel E, et al. Příprava k operaci s perorálním příjmem v den plánované operace. Rozhl Chir. 2006;11:554–559.
  22. Drábková J. Perioperační nutrice – význam a nutnost edukace pacientů. Anest Intenziv Med. 2017;6:366.
  23. Adamová Z, Slováček R, Romanová G. ERAS v kolorektální chirurgii – opomíjená přednemocniční část. Rozh Chir. 2019;11:345–349.
  24. Polle SW, Wind J, Fuhring JW, et al. Implementation of a fast-track perioperative care program: what are the difficulties? Dig Surg. 2007;24:441–449. doi:10.1159/000108327.
  25. Ahmed J, Khan S, Gatt M, et al. Compliance with enhanced recovery programmes in elective colorectal surgery. Br J Surg. 2010  May;97(5):754–758.  doi:10.1002/bjs.6961.
  26. Ahmed J, Khan S, Lim M, et al. Enhanced recovery after surgery protocols – compliance and variations in practice during routine colorectal surgery. Colorectal Dis. 2012 Sep;14(9):1045–1051. doi:10.1111/j.1463-1318.2011.02856.x.
Labels
Surgery Orthopaedics Trauma surgery
ERAS
Methodology for implementing early recovery after surgery protocols in colorectal surgery
Prehabilitation bundle can reduce incidence of postoperative pulmonary complications
Clinical practice guidelines for perioperative care in bariatric surgery 2023: Adapted ERAS (enhanced recovery after surgery) guidelines with consensual voting of the working group of the Joint Bariatric and Metabolic Surgery Section of the Czech Surgery…
Z 9. světového kongresu společnosti ERAS – Lisabon 2023
Article was published in

Perspectives in Surgery

Issue 7
2023 Issue 7
Most read in this issue
Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#