Influence of pre-surgery nutritional intervention on the hospital stay in patients with digestive cancer.
DOI:
https://doi.org/10.12873/441nebotKeywords:
Desnutrición, cáncer digestivo, estancia hospitalaria, suplementación nutricionalAbstract
Introduction: Hospital malnutrition in digestive cancer
patients requiring surgery has a high prevalence and represents an increase in post-surgical complications, hospital stay and its associated costs.
Objectives: The main objective is to analyze whether presurgery nutritional intervention in patients with digestive cancer has an impact on hospital stay. The secondary objectives are to analyze the nutritional status before surgery, to see if there is correlation between nutritional analytical markers and the length of hospital stay and between receiving preoperative nutritional intervention and the evolution of anthropometric parameters
Material and Methods: Prospective 1-year study in which
88 patients with digestive cancer requiring surgery were included. The hospital stay was compared between a group of these patients who received nutritional intervention presurgery and another group that did not receive it.
Results: 47 patients were included in the intervention
group and 41 in the control group. Among the patients evaluated (intervention group), malnutrition was 29,5% before surgery and 64% after surgery. Oral nutritional supplementation reached 80% of malnourished or at-risk patients, starting in 51% of them before surgery. Significant differences of less than 5 days of hospitalization were observed in patients in the intervention group.
Discussion: The difference in the days of hospitalization in
the intervention group could be due to the intervention and
nutritional supplementation prior to surgery since both received nutritional treatment during hospitalization in the same proportion.
Conclusions: The nutritional assessment of these patients
prior to surgery allows us to detect patients at risk of malnutrition or already established malnutrition and significantly reduce hospital stay by up to 5 days.
References
Vaamonde JG, Buey GG, Valero ML. Desnutrición hospitalaria. Medicine [Internet]. 2022;13(69):4045–53. Disponible en:
http://dx.doi.org/10.1016/j.med.2022.12.002
Barreiro Domínguez E, Santos S, Miranda B, Dacosta C, Corbal P, Jueguen D. Factores pronósticos de desnutrición en pacientes con
cáncer colorrectal. Nutrición Hospitalaria. 2022;39(6):1306–15.
Murillo AZ, Jáuregui EP, Ciaurriz CR, Sánchez RS, Villazón F, Faes ÁGD. SeDREno study:: Prevalence of hospital malnutrition according to glim criteria, ten years after the predyces study. Nutrición hospitalaria: Organo oficial de la Sociedad española de nutrición parenteral y enteral. J J. 2021;38(5):1016–25.
Planas M, Álvarez-Hernández J, León-Sanz M, Celaya-Pérez S, Araujo K, García de Lorenzo A, et al. Prevalence of hospital malnutrition in cancer patients: a sub-analysis of the PREDyCES® study. Support Care Cancer [Internet]. 2016;24(1):429–35. Disponible en: http://dx.doi.org/10.1007/s00520-015-2813-7
Valero ML, Gutiérrez-Buey G, Vaamonde JG. Nutrición en el perioperatorio. Situaciones clínicas específicas tras una cirugía digestiva. Medicine [Internet]. 2022;13(69):4037–44. Disponible en: http://dx.doi.org/10.1016/j.med.2022.12.001
Lobatón E. Malnutrición hospitalaria: etiología y criterios para su diagnóstico y clasificación. Rev Nutr Clin Metab [Internet].
;3(1):121–7. Disponible en: http://dx.doi.org/10.35454/rncm.v3n1.019
Leiva Badosa E, Badia Tahull M, Virgili Casas N, Elguezabal Sangrador G, Faz Méndez C, Herrero Meseguer I, et al. Nutr Hosp
[Internet]. 2017;34(4):907–13. Disponible en: http://dx.doi.org/10.20960/nh.657
Gupta A, Gupta E, Hilsden R, Hawel JD, Elnahas AI, Schlachta CM, et al. Preoperative malnutrition in patients with colorectal
cancer. Can J Surg [Internet]. 2021;64(6):E621–9. Disponible en: http://dx.doi.org/10.1503/cjs.016820
Aro R, Ohtonen P, Rautio T, Saarnio J, Mäkäräinen E, Häivälä R. Perioperative oral nutritional support for patients diagnosed with
primary colon adenocarcinoma undergoing radical surgical procedures-Peri-Nutri Trial: study protocol for a randomized controlled
trial. BMC nutrition. 2022;8(1):1–11.
León Sanz M. A critical review of the GLIM criteria. Nutr Hosp [Internet]. 2021;38(Spec1):29–33. Disponible en: http://dx.doi.org
/10.20960/nh.03558
Weimann A, Braga M, Carli F, Higashiguchi T, Hübner M, Klek S, et al. ESPEN practical guideline: Clinical nutrition in surgery. Clin Nutr
[Internet]. 2021;40(7):4745–61. Disponible en: http://dx.doi.org/10.1016/j.clnu.2021.03.031
Zunzunegui P, García A, Cruz M, Cebrián F, Montserrat C, Sánchez M. Impacto de la implantación de un programa nutricional preoperatorio en pacientes de cirugía colorrectal. Rev esp enferm dig. 2020;909–14.
Yeung SE, Hilkewich L, Gillis C, Heine JA, Fenton TR. Protein intakes are associated with reduced length of stay: a comparison
between Enhanced Recovery After Surgery (ERAS) and conventional care after elective colorectal surgery. Am J Clin Nutr [Internet]. 2017;106(1):44–51. Disponible en: http://dx.doi.org/10.3945/ajcn.116.148619
Soeters PB. The Enhanced Recovery After Surgery (ERAS) program: benefit and concerns. Am J Clin Nutr [Internet]. 2017; 106(1):10–1. Disponible en: http://dx.doi.org/10.3945/ajcn.117.159897105
Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, et al. ESPEN practical guideline: Clinical Nutrition in cancer. Clin Nutr [Internet]. 2021;40(5):2898–913. Disponible en: http://dx.doi.org/10.1016/j.clnu.2021.02.005
Lozano EC, Zárate VO, Portillo RC. Manejo nutricional del paciente con cáncer gástrico. Endocrinología, Diabetes y Nutrición.
;68:428–38.
Bullock AF, Greenley SL, McKenzie GAG, Paton LW, Johnson MJ. Relationship between markers of malnutrition and clinical outcomes in older adults with cancer: systematic review, narrative synthesis and meta-analysis. Eur J Clin Nutr [Internet]. 2020;74(11):1519–35. Disponible en: http://dx.doi.org/10.1038/s41430-020-0629-0
Muresan BT, Jiménez-Portilla A, Artero A, Ruiz Berjaga Y, Llamas Montero M del M, Lobo de Mena M, et al. Nutritional assessment
and intervention in hospitalized cancer patients at risk of or with malnutrition: evaluation of the effect on anthropometric and body
composition parameters. Nutr Hosp [Internet]. 2022; Disponible en: http://dx.doi.org/10.20960/nh.04219
Fernández López MT, Saenz Fernández CA, Trinidad De Sás Prada M, Urrutia SA, Luisa M, Alonso B, et al. Desnutrición en pacientes
con cáncer; una experiencia de cuatro años [Internet]. Disponible en: http://dx.doi.org/10.3305/nh.2013.28.2.6239
Manzanares Campillo M del C, Martín Fernández J, Amo Salas M, Casanova Rituerto D. Estudio prospectivo y randomizado sobre inmunonutrición oral preoperatoria en pacientes intervenidos por cáncer colorrectal: estancia hospitalaria y costos sanitarios. Cir Cir
[Internet]. 2017;85(5):393–400. Disponible en: http://dx.doi.org/10.1016/j.circir.2016.10.029
Ortiz Martínez K, Ugarte Martínez P, Gaytán García CJ, Ruiz Álvarez M, Martínez Díaz BA, Aguirre Sánchez JS. Impacto de la
nutrición enteral temprana en la mortalidad y días de estancia en la unidad de cuidados intensivos. Medicina Crítica [Internet].
;36(8):496–9. Disponible en: http://dx.doi.org/10.35366/109169
Robledo-Valdez M, Cervantes-Pérez E, Cervantes-Guevara G, Cervantes-Cardona GA, Ramírez-Ochoa S, González-Ojeda A, et
al. Conceptos actuales sobre el soporte nutricional preoperatorio: ¿cómo, cuándo y por qué? Cir Cir [Internet]. 2022;90(4). Disponible en: http://dx.doi.org/10.24875/ciru.20000893
García Martínez T, Montañés Pauls B, Vicedo Cabrera A, Llueca A, Escrig-Sos J, Herraiz Roda JL. Evaluación y soporte nutricional en
pacientes con carcinomatosis peritoneal por cáncer de ovario con citorreducción quirúrgica. Nutr. clín. diet. hosp. 2016; 36(1):31-40
Espitia OL, Rodríguez JL. Tendencias de los análisis de costos de las tecnologías en soporte nutricional enteral en pacientes hospitalizados: revisión de literatura. Rev Esp Nutr Comunitaria. 2019;25(2):78–84
Palma Milla S, Meneses Gonzalez D, Valero Pérez M, Calso González M, García Vázquez N, Ruiz Garrido M, et al. Costes asociados a la desnutrición relacionada con la enfermedad y su tratamiento: revisión de la literatura. Nutr Hosp [Internet]. 2018; Disponible en: http://dx.doi.org/10.20960/nh.1204
Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F, et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr
[Internet]. 2017;36(1):11–48. Disponible en: http://dx.doi.org/10.1016/j.clnu.2016.07.015
Camblor-Álvarez M, Ocón-Bretón MJ, Luengo-Pérez LM, Viruzuela JA, Sendrós-Maroño MJ, Cervera-Peris M, et al. Soporte nutricional y nutrición parenteral en el paciente oncológico: informe de consenso de un grupo de expertos. Nutr Hosp [Internet]. 2018; Disponible en: http://dx.doi.org/10.20960/nh.1361
Downloads
Published
How to Cite
License
Copyright (c) 2023 Nutrición Clínica y Dietética Hospitalaria
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los lectores pueden utilizar los textos publicados de acuerdo con la definición BOAI (Budapest Open Access Initiative)
