手术康复加速作为一个审计框架，用于确定如何改善老年手术患者围手术期营养护理。

Enhanced Recovery After Surgery as an auditing framework for identifying improvements to perioperative nutrition care of older surgical patients.

机构信息

School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia.

Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.

出版信息

Eur J Clin Nutr. 2018 Jun;72(6):913-916. doi: 10.1038/s41430-017-0049-y. Epub 2017 Dec 29.

DOI:10.1038/s41430-017-0049-y

PMID:29288246

Abstract

Older patients are at increased risk of malnutrition and reduced physical function. Using Enhanced Recovery After Surgery (ERAS) guidelines as an auditing framework, this study aimed to determine adherence of nutrition care to perioperative best practice in older patients. A single researcher retrieved data via chart review. Seventy-five consenting patients ≥65 years (median 72 (range 65-95) years, 61% male) admitted postoperatively to general surgical wards were recruited. Sixty per cent had a primary diagnosis of cancer and 51% underwent colorectal resection. Seventeen per cent and 4% of patients met fasting targets of 2-4 h for fluid and 6-8 h for food, respectively. Fifty-five per cent were upgraded to full diet by first postoperative day. Nil received preoperative carbohydrate loading. Minimally invasive surgery (p = 0.01) and no anastomosis formation (p = 0.05) were associated with receiving ERAS-concordant nutrition care. This study highlights areas for improvement in perioperative nutrition care of older patients at our facility.

摘要

老年患者存在营养不良和身体功能下降的风险增加。本研究以增强术后恢复（ERAS）指南为审核框架，旨在确定围手术期最佳实践中对老年患者营养护理的依从性。一名研究人员通过病历回顾检索数据。共招募了 75 名同意入组的术后转入普外科病房的年龄≥65 岁的患者（中位数 72（范围 65-95）岁，61%为男性）。60%的患者有癌症的主要诊断，51%的患者接受了结直肠切除术。分别有 17%和 4%的患者满足液体禁食 2-4 小时和固体禁食 6-8 小时的目标。55%的患者在术后第 1 天升级为全饮食。没有患者接受术前碳水化合物负荷。微创手术（p=0.01）和无吻合口形成（p=0.05）与接受 ERAS 一致的营养护理相关。本研究突出了我们机构围手术期老年患者营养护理需要改进的领域。