PT53 - ORAL INTAKE AND MEDICAL NUTRITION IN POSTOPERATIVE DIGESTIVE SURGICAL PATIENTS: CHANGES IN HABITS OVER TIME AND ASSOCIATION WITH OUTCOMES. RESULTS FROM NUTRITIONDAY 2006-2023

PT53

ORAL INTAKE AND MEDICAL NUTRITION IN POSTOPERATIVE DIGESTIVE SURGICAL PATIENTS: CHANGES IN HABITS OVER TIME AND ASSOCIATION WITH OUTCOMES.

RESULTS FROM NUTRITIONDAY 2006-2023

M. Sandini^1,*, O. Ljungqvist², L. Gianotti³, S. Tarantino⁴, A. Schartmann⁴, P. Bauer⁴, M. Hiesmayr⁴

¹1.    Dept. of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Siena, Italy, ²School of Medical Sciences, Dept. of Surgery, Örebro University, Örebro , Sweden, ³3.     School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy, ⁴4. Center for Medical Data Science, Institute of Medical Statistics, Medical University of Vienna, Vienna, Austria

Rationale: Previous nutritionDay (nDay) results showed that nearly half of hospitalized patients do not eat their full meal, and this is associated with increased hospital mortality. The risk was higher in surgical patients (1, 2). Aim of this study was to explore nutritional habits in postoperative digestive patients, to analyze the use of medical nutrition therapy (MNT) and assess associations with short-term outcomes.

Methods: The nDay 2006-2023 cohort (n:222101) includes 99624 surgical patients. 16025 of 29791 gastrointestinal surgery patients were postoperative with documented time since surgery. We used a multivariable logistic model to determine factors that modify the use of MNT and the association with 30-day hospital mortality (STATA 15.1 GLM).

Results: The majority of patients (13325, 82%) were within 9 days following surgery. About 6572 (45%) ate a quarter of the served meal or nothing on nDay, and 3567 (22%) received MNT. At the 5-year period analysis, we observed an increased rate of full-meal eaters (24% to 25%) and a decreased rate of patients not allowed to eat (22% to 14%). The use of MNT dropped in full-eaters and raised up in non-eaters. MNT was independently associated with increased mortality [OR 2.55 (1.73-3.77)], along with reduced intake on nDay, age, and limited mobility. When modeling the interaction with 5-year periods, the negative effect of MNT disappeared over time (Figure 1).

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Conclusion: Postoperative nutritional care of surgical digestive patients has changed in the last 20 years. Earlier resumption of oral intake after surgery and appropriate indications for MNT appeared to reduce the risk of 30-day mortality.

References: 1.Hiesmayr M et al. PLoS One. 2015

2.Correia M et al. Clin Nutr. 2021

Disclosure of Interest: None declared