Impact of the nutritional risk score in fast-track colon surgery

Dig Surg. 2010;27(5):436-9. doi: 10.1159/000313692. Epub 2010 Nov 5.

Abstract

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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colon / surgery*
  • Female
  • Humans
  • Length of Stay*
  • Male
  • Middle Aged
  • Nutrition Assessment*
  • Nutritional Status*
  • Postoperative Complications / epidemiology*
  • Risk Factors

Associated data

  • ClinicalTrials.gov/NCT00556790