Calorie Supplementation Is Crucial After GI Surgery

Gastrointestinal (GI) surgery recipients who do not receive adequate calorie supplementation following surgery have an increased risk of 30-day mortality, a new study showed.

Findings from the study were presented at the American Society for Parenteral and Enteral Nutrition (ASPEN) 2018 Nutrition Science & Practice Conference, which is taking place from January 22 to 25 in Las Vegas, Nevada.
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For their study, the researchers assessed the medical records of 249 patients with intra-abdominal infection following GI surgery between January 2007 and December 2016. All patients included in the study required intensive care unit (ICU) stay with mechanical ventilator (MV) support for more than 24 hours following surgery.

The researchers calculated modified Nutrition Risk in the Critically Ill (mNUTRIC) scores and calorie adequacy (defined as caloric supplementation of more than 70% of required calories) for each patient. Between-group baseline differences were accounted for via propensity score matching.

In patients with high mNUTRIC scores, calorie inadequacy was associated with a higher rate of 30-day mortality compared with those receiving adequate nutrition (35.6% VS 13.3%). However, this was not observed in patients with low mNUTRIC scores. In this group, calorie inadequacy was not found to be associated with postoperative leakage (13.3% vs 11.1%), wound complication (31.1% vs 35.6%), or pulmonary complication (53.3% vs 60.0%).

“Inadequate calorie supplementation after GI surgery is associated with higher 30-day mortality in patients with high mNUTRIC score,” the researchers concluded. “Adequate supplementation of calorie for critically ill post-operative patients in high nutritional risk could contribute to improvement in their survival.”

—Christina Vogt

Reference:

Kim MJ, Lee JG, Jung YT. Association of calorie adequacy with 30-day mortality in critically ill surgical patients with high modified NUTRIC score. Paper presented at: ASPEN 2018 Nutrition Science & Practice Conference. January 22-25, 2018. Las Vegas, NV.  https://www.nutritioncare.org/uploadedFiles/Documents/ASPEN_2018/ASPEN18_Abstracts/NUTRITION AND METABOLISM PAPER SESSIONS 2018.pdf