Background: Perioperative nutrition support is recommended for patients undergoing upper gastrointestinal (UGI) cancer surgery; however, limited evidence exists regarding implementation of a nutrition care pathway in clinical practice. The aims of this pilot study were to determine whether implementation of a standardised perioperative nutrition pathway for patients undergoing UGI cancer surgery improves access to dietetics care, as well as to evaluate study feasibility, fidelity, resource requirements and effect on clinical outcomes.
Methods: Patients with newly diagnosed UGI cancer from four major metropolitan hospitals in Melbourne, planned for curative intent surgery, were included in the prospective pilot study (n = 35), with historical controls (n = 35) as standard care. Outcomes were dietetics care (dietetics contacts) nutritional status, hand grip strength, weight change, preoperative hospital admissions, complications and length of stay, recruitment feasibility, fidelity and adherence, and resource requirements. Continuous data were analysed using independent samples t test accounting for unequal variances or a Mann-Whitney U test. Dichotomous data were analysed using Fisher's exact test.
Results: The percentage of participants receiving preoperative dietetic intervention increased from 55% to 100% (p < 0.001). Mean ± SD dietetics contacts increased from 2.2 ± 3.7 to 5.9 ± 3.9 (p < 0.001). Non-statistically significant decreases in preoperative nutrition-related hospital admissions, and surgical complications were demonstrated in patients who underwent neoadjuvant therapy. Recruitment rate was 81%, and adherence to the nutrition pathway was high (> 70% for all stages of the pathway). The mean ± SD estimated resource requirement for the preoperative period was 3.7 ± 2.8 h per patient.
Conclusions: Implementation of this standardised nutrition pathway resulted in improved access to dietetics care. Recruitment feasibility and high fidelity to the intervention suggest that a larger study would be viable.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/jhn.13018 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Preoperative myosteatosis and perioperative serum chloride levels predict 180 day major complications after radical cystectomy.
Sci Rep
January 2025
Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
This study aimed to investigate the role of myosteatosis, sarcopenia, and perioperative serum biomarkers as independent predictors of major complications within 180 days following radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC). We retrospectively analyzed of 127 MIBC patients who underwent RC between 2013 and 2023 at a single institution. Preoperative body composition was assessed using CT scans at the L3 vertebral level to measure psoas muscle density (PMD), skeletal muscle density (SMD), axial muscle density (AMD), and muscle indices.
View Article and Find Full Text PDFHigh Geriatric Nutritional Risk Index Risk as a Predictor of Postoperative Complications and Early Mortality in Older Adult Patients Undergoing Pancreatoduodenectomy for Periampullary Malignancies.
J Clin Med
January 2025
Division of General Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123, Dapi Road, Niaosong District, Kaohsiung 833, Taiwan.
Pancreaticoduodenectomy (PD) is a major surgery associated with significant morbidity and mortality, especially in older adult patients. Malnutrition is a common complication in these patients and is linked to poorer outcomes. This study aimed to investigate the associations between preoperative nutritional status using the Geriatric Nutritional Risk Index (GNRI) and postoperative outcomes in older adult patients who underwent PD.
View Article and Find Full Text PDFAssociation of Admission Nutritional Status Evaluated by Prognostic Nutritional Index with One-Year Walking Independence after Primary Total Hip Arthroplasty for Osteonecrosis of the Femoral Head: A Retrospective Matched Cohort Study Based on 1,152 Patients.
J Arthroplasty
January 2025
Department of Orthopedic Surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China; Orthopedic Research Institute of Hebei Province, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China.
Background: Malnutrition is significantly associated with unfavorable outcomes, but the relevant prognostic assessment is not emphasized in patients who have osteonecrosis of the femoral head (ONFH). This study aimed to assess the association between preoperative nutritional status evaluated by the prognostic nutritional index (PNI) and walking independence at one year postoperatively in patients who have ONFH undergoing primary total hip arthroplasty (THA).
Methods: This was a retrospective analysis of prospectively collected data from patients admitted to a tertiary referral hospital who had ONFH and underwent primary unilateral THA from October 30, 2014 to April 26, 2019.
Perioperative Supportive Care Interventions to Enhance Surgical Outcomes for Older Adults With Cancer: A Systematic Review.
JCO Oncol Pract
January 2025
Section of Hematology & Oncology, Department of Medicine, University of Oklahoma Health Sciences Center, Stephenson Cancer Center, Oklahoma City, OK.
Purpose: Older adults with cancer have unique needs, which likely influence surgical outcomes in the geriatric oncology population. We conducted a systematic review to describe the literature focused on perioperative supportive care interventions for older adults with cancer undergoing surgery.
Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases for literature published from January 2010 to October 2023.
Long-Term Oncological Outcomes Related to Lymphadenectomy in Clinical Stage I NSCLC: A Multicenter Retrospective Experience.
Curr Oncol
January 2025
Unit of Thoracic Surgery, Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, 87036 Rende, Italy.
Background: Lymphadenectomy is considered a key part of the radical treatment of resectable lung cancer, although its appropriate extension in early stages is a debated topic due to the great heterogeneity of studies in the literature. This study aims to evaluate the impact of lymphadenectomy extent on survival and recurrence in the treatment of early-stage NSCLC patients undergoing lobectomy and lymph node dissection.
Methods: Data from clinical stage I NSCLC patients undergoing lobectomy and hilar-mediastinal lymphadenectomy at two thoracic surgery centers from 2016 to 2019 were retrospectively evaluated.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!