Ordering a Normal Diet at the End of Surgery-Justified or Overhasty?

Fabian Grass, Martin Hübner, Jenna K. Lovely, Jacopo Crippa, Kellie L. Mathis, David Larson

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Early re-alimentation is advocated by enhanced recovery pathways (ERP). This study aimed to assess compliance to ERP-set early re-alimentation policy and to compare outcomes of early fed patients and patients in whom early feeding was withhold due to the independent decision making of the surgeon. For this purpose, demographic, surgical and outcome data of all consecutive elective colorectal surgical procedures (2011⁻2016) were retrieved from a prospectively maintained institutional ERP database. The primary endpoint was postoperative ileus (POI). Surgical 30-day outcome and length of stay were compared between patients undergoing the pathway-intended early re-alimentation pattern and patients in whom early re-alimentation was not compliant. Out of the 7103 patients included, 1241 (17.4%) were not compliant with ERP re-alimentation. Patients with delayed re-alimentation presented with more postoperative complications (37 vs. 21%, p < 0.001) and a prolonged length of hospital stay (8 ± 7 vs. 5 ± 4 days, p < 0.001). While male gender (odds ratio (OR) 1.24; 95% confidence interval (CI) 1.04⁻1.32), fluid overload (OR 1.38; 95% CI 1.16⁻1.65) and high American Society of Anaesthesiologists (ASA) score (OR 1.51; 95% CI 1.27⁻1.8) were independent risk factors for POI, laparoscopy (OR 0.51; 95% CI 0.38⁻0.68) and ERP compliant diet (OR 0.46; 95% CI 0.36⁻0.6) were both protective. Hence, this study provides further evidence of the beneficial effect of early oral feeding after colorectal surgery.

Original languageEnglish (US)
JournalNutrients
Volume10
Issue number11
DOIs
StatePublished - Nov 14 2018

Fingerprint

repletion
odds ratio
surgery
confidence interval
Diet
Odds Ratio
Confidence Intervals
diet
Length of Stay
Ileus
intestinal obstruction
Elective Surgical Procedures
Colorectal Surgery
laparoscopy
postoperative complications
surgeons
endpoints
compliance
Laparoscopy
decision making

Keywords

  • colorectal
  • enhanced recovery
  • nutrition

ASJC Scopus subject areas

  • Food Science
  • Nutrition and Dietetics

Cite this

Grass, F., Hübner, M., Lovely, J. K., Crippa, J., Mathis, K. L., & Larson, D. (2018). Ordering a Normal Diet at the End of Surgery-Justified or Overhasty? Nutrients, 10(11). https://doi.org/10.3390/nu10111758

Ordering a Normal Diet at the End of Surgery-Justified or Overhasty? / Grass, Fabian; Hübner, Martin; Lovely, Jenna K.; Crippa, Jacopo; Mathis, Kellie L.; Larson, David.

In: Nutrients, Vol. 10, No. 11, 14.11.2018.

Research output: Contribution to journalArticle

Grass, F, Hübner, M, Lovely, JK, Crippa, J, Mathis, KL & Larson, D 2018, 'Ordering a Normal Diet at the End of Surgery-Justified or Overhasty?', Nutrients, vol. 10, no. 11. https://doi.org/10.3390/nu10111758
Grass, Fabian ; Hübner, Martin ; Lovely, Jenna K. ; Crippa, Jacopo ; Mathis, Kellie L. ; Larson, David. / Ordering a Normal Diet at the End of Surgery-Justified or Overhasty?. In: Nutrients. 2018 ; Vol. 10, No. 11.
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