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A9. A study of nutritional intake in surgical patients, pre‐ and post‐operatively

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Abstract:

Background Those who undergo major surgery are at a greater risk of malnutrition than most because of the stress and the concomitant increase in metabolic rate ( Edington, 1997). Malnutrition often goes unrecognized in hospitals ( Lennard Jones, 1992) increasing morbidity and mortality as well as the length of hospital stay and cost to the NHS. Treatment of the malnourished patient by nutritional support ( Rana et al., 1992 ) and artificial nutritional support ( Beiser‐Holgeren et al., 1996 ) has produced beneficial results.

Aim To examine the nutritional intakes of surgical patients pre‐ and post‐operatively and identify the factors associated with nutritional intake.

Methods The study identified the nutritional intakes of surgical patent’s 1 day preoperatively and on two occasions postoperatively (3–5 days and 7–12 days). Also investigated were reasons why, if any, surgical patients were not meeting their nutritional requirements, the contribution of artificial nutritional support to patients’ requirements and patients’ acceptability of the hospital catering system. 50 surgical patients undertook a 24‐h dietary recall at the stated assessment periods. Statistical tests were used to analyse the variance (anova) and correlation of all data.

Results It was found that only 24% of patients were meeting nutritional requirements preoperatively. Only 6% met their requirements in the first postoperative period and only 18% in the second.

Patients undergoing gastro‐intestinal surgery were found to be at the greatest nutritional risk.

Patients who received artificial nutritional support (naso‐gastric and naso‐jejunal) had the highest nutritional intakes in the postoperative periods.

Supplementary drinks substantially increased nutritional intakes.

Medical and surgical reasons were identified for patients’ reduced intakes not patient dissatisfaction with the hospital catering system.

Conclusion These results show that malnutrition is still apparent on today’s surgical wards. Patients continue to be nutritionally deficient whilst in hospital. The education of all health care professionals on the subject of nutrition must therefore be seen as of paramount importance.

Document Type: Abstract

DOI: http://dx.doi.org/10.1046/j.1365-277x.2000.00001-10.x

Affiliations: Department of Nutrition & Dietetics, University of Wales Institute, Cardiff

Publication date: October 1, 2000

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