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December 10, 2025Open Access

Effectiveness of nutrition support team-led care on perioperative outcomes in malnourished older adults with gastric cancer

Key Points

Lower rates of anastomotic leakage and infection were observed in the NST group compared to conventional nutrition management.
The NST group achieved better energy and protein intake compliance, leading to improved clinical outcomes in older adults.
Analysis of retrospective cohort data confirmed that NST significantly improved bowel movement timing and reduced hospitalization duration.
These findings suggest that incorporating NST into routine care for older adults with gastric cancer may enhance recovery outcomes.

Abstract

Background Malnutrition is a prevalent complication in older adults with gastric cancer and significantly impacts postoperative outcomes following curative gastrectomy. This study aimed to investigate the clinical value of nutrition support team (NST) in the perioperative management of gastric cancer older adults with concomitant malnutrition. Methods This retrospective cohort study included patients aged ≥65 years who underwent curative gastrectomy and met the Global Leadership Initiative on Malnutrition (GLIM) criteria for malnutrition between 2021 and 2024. Outcomes were compared between the NST group and conventional nutritional management group to analyze differences in nutritional support efficacy and clinical outcomes. Results NST group showed lower mortality at day 1 and 30 (0.0 vs. 0.4%, 0.8 vs. 4.6%, P 0.05) and higher compliance for energy (71.4 vs. 10.0%, P 0.001) and protein intake (56.0 vs. 10.8%, P 0.001) compared to traditional nutrition (TN) group. Prognostic nutritional index (PNI) 46.60 (43.45, 50.05), P 0.0001; 47.30 (43.45, 50.05), P 0.0001 and prealbumin 136.8 (123.2, 172.0), P 0.0001; 157.0 (128.2, 183.4), P 0.0001 were significantly higher in NST group at day 7 and discharge. NST reduced the incidence of anastomotic leakage (1.7 vs. 5.0%, P 0.05) and infection rates (4.5 vs. 10.4%, P 0.05), weight loss at day 7 and before discharge 2.12 ± 0.10% (95% CI: 1.95, 2.28) vs. 6.63 ± 0.20% (95% CI: 6.23, 7.03), P 0.001; 1.92 ± 0.07% (1.78, 2.07) vs. 6.53 ± 0.20% (6.13, 6.93), P 0.001. NST group had a shorter length of stay 15.00 (14.00, 17.00), P 0.05, postoperative stay 12.00 (9.00, 14.00), P 0.05, and lower readmission rates (10.8 vs. 17.8%, P 0.05). NST significantly reduced the time to drain removal after surgery 9.00 (8.00, 11.00), P 0.001, time to first flatus 3.00 (3.00, 3.00), P 0.001 and bowel movement 4.00 (4.00, 4.00), P 0.001 were shorter in NST group. Conclusion Our results demonstrated that NST intervention was associated with superior postoperative survival outcomes in malnourished older adults with gastric cancer. These findings supported that NST may serve as a valuable component of routine perioperative care for this vulnerable population.

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