PD1062 - ECONOMIC AND CLINICAL IMPACT OF EARLY POSTOPERATIVE ORAL NUTRITION SUPPLEMENTATION IN OBSTETRIC PATIENTS:EVIDENCE TO ADVANCE ERAC PATHWAYS-A RETROSPECTIVE COHORT STUDY
PD1062
ECONOMIC AND CLINICAL IMPACT OF EARLY POSTOPERATIVE ORAL NUTRITION SUPPLEMENTATION IN OBSTETRIC PATIENTS:EVIDENCE TO ADVANCE ERAC PATHWAYS-A RETROSPECTIVE COHORT STUDY
W. Selima1, T. Ohnuma2, V. Krishnamoorthy2, K. Raghunathan2, P. Wischmeyer3, K. Haines4, E. Garcia-Velasquez5,*
1Anesthesia, critical care and pain management, Ain shams university, Cairo, Egypt, 2CAPER, 3Anesthesiology, 4Surgery , trauma, and critical care surgery, Duke university, North carolina, United States, 5Nutrition, Kennedy Group Hospital, Guayaquil, Ecuador
Rationale: Perioperative nutrition is fundamental to Enhanced Recovery After Cesarean Section (ERAC) protocols. Early oral nutritional supplementation (ONS) has demonstrated its efficacy across various surgical specialties. This study sought to examine the association between the early postoperative ONS and hospital length of stay (LOS) and patient cost in cesarean section.
Methods: A retrospective cohort analysis utilized the Premier Healthcare database, including patients who underwent cesarean delivery from 2018 to 2023. Patients who received ONS within 2 days post-surgery were compared to those who received ONS after this timeframe. The primary outcomes comprised LOS and hospital costs. The propensity score weighting analysis was conducted, adjusting for confounding factors.
Results: We identified 937 patients with ONS. Of those, 490 patients received ONS within 2 days of the surgery. Baseline characteristics included age, race, insurance, study year, obstetric risk factors, and comorbidity score. early ONS was associated with a decrease in mean LOS, 5.3 ± 9.9 days in no early ONS versus 3.8 ± 5.9 days in early ONS (Mean rate ratio=0.75, 95% CI 0.68-0.84; p < 0.001). Similarly, early ONS was associated with lower total hospital costs: $15278 ± 36091 in no early ONS versus $12136 ± 26300 in early ONS (Mean rate ratio = 0.86, 95% CI 0.78-0.95; p-value = 0.0028).
Conclusion: Early postoperative ONS after cesarean delivery was associated with significant decreases in perioperative resource consumption and healthcare expenditures. These findings support the incorporation of early ONS into standardized ERAC pathways. Prospective studies are needed to determine causal effects and optimal implementation strategies.
Disclosure of Interest: None declared