P1053 - TEMPORAL ASSOCIATION OF PARENTERAL NUTRITION AND POSTOPERATIVE COMPLICATIONS AFTER EMERGENCY LAPAROTOMY

P1053

TEMPORAL ASSOCIATION OF PARENTERAL NUTRITION AND POSTOPERATIVE COMPLICATIONS AFTER EMERGENCY LAPAROTOMY

J. B. Hansen^1,*, J. B. Knoblauch¹, C. B. Bech¹, D. K. Gellert-Kristensen¹, J. Burcharth¹

¹Emergency Surgery Research Group Copenhagen, Copenhagen University Hospital Herlev, Herlev, Denmark

Rationale: Parenteral nutrition (PN) is used when patients are unable to achieve adequate enteral nutrition. The aim of this study was to describe the temporal association between postoperative complications and PN after emergency laparotomy.

Methods: A single-center retrospective cohort study of consecutive patients undergoing emergency laparotomy for bowel obstruction, bowel perforation, or bowel ischemia at Copenhagen University Hospital Herlev from August 2021 to August 2022. All complications occurring both prior and after initiation of parenteral nutrition were recorded and graded using the Clavien-Dindo Classification (CDC) with serious complications defined as grade ≥ 3a.

Results: In the study period, 231 patients underwent major emergency surgery. PN was used in 66 (28.6%), and the median time from surgery to initiation of PN was four days (IQR 3-6.8). 43 (65.5%) were male, and median age was 71. (IQR 58-79). Bowel obstruction was found in 35 (53%) of patients. The median postoperative length of stay was 17 days (IQR 13-29.8). In total, 25 serious complications occurred from three days prior to day of first dose of PN, and 13 serious complications occurred in the first four days after PN start.

In 13 patients, PN was started prior to the occurrence of any postoperative complication. In these, duration of surgery was significantly longer compared to patients who started PN on the day of the first complication or later (p < 0.001). No difference in 30-day mortality, ASA score, performance status or intraoperative pathology between the groups was found.

Conclusion: Start of PN was often used in close temporal relation to a serious postoperative complication. No difference in 30-day mortality, operative findings or pre-existing comorbidity was seen in patients who received PN prior to the occurrence of any postoperative complication compared to patients receiving PN after a complication had occurred.

Disclosure of Interest: None declared