Key result
The NutriCatt protocol significantly reduced severe complications compared to standard ERAS in elderly patients undergoing colorectal surgery (OR 0.10; 95% CI 0.01-0.56; p=0.009).
Why the study?
Poor body composition often found in elderly patients negatively impacts perioperative outcomes, motivating evaluation of a perioperative nutritional protocol within an ERAS program.
Does the NutriCatt protocol improve body composition and clinical outcomes in elderly patients undergoing colorectal surgery in an ERAS program?
Cohort (n=302)
No
Does the NutriCatt protocol improve body composition and clinical outcomes in elderly patients undergoing colorectal surgery in an ERAS program?
The NutriCatt nutritional protocol significantly improves body composition and reduces severe complications and length of hospital stay in elderly patients undergoing colorectal surgery.
Supports adding personalized nutrition to ERAS for elderly colorectal patients; leaves open need for randomized trials to confirm benefits.
Background: A poor body composition, often found in elderly patients, negatively impacts perioperative outcomes. We evaluated the effect of a perioperative nutritional protocol (NutriCatt) on body composition and clinical outcomes in a cohort of elderly patients undergoing colorectal surgery in a high-volume center adopting the ERAS program. Methods: 302 out of 332 elderly (>75 years) patients from 2015 to 2020 were identified. Patients were divided according to their adherence, into “NutriCatt + ERAS” (n = 166) or “standard ERAS” patients (n = 136). Anthropometric and bioelectrical impedance analysis data were evaluated for NutriCatt + ERAS patients. Complications, length of hospital stay (LOS), and other postoperative outcomes were compared between both groups. Results: In NutriCatt + ERAS patients, significant improvements of phase angle (pre-admission vs. admission 4.61 ± 0.79 vs. 4.84 ± 0.85; p = 0.001; pre-admission vs. discharge 4.61 ± 0.79 vs. 5.85 ± 0.73; p = 0.0002) and body cell mass (pre-admission vs. admission 22.4 ± 5.6 vs. 23.2 ± 5.7; p = 0.03; pre-admission vs. discharge 22.4 ± 5.6 vs. 23.1 ± 5.8; p = 0.02) were shown. NutriCatt + ERAS patients reported reduced LOS (p = 0.03) and severe complications (p = 0.03) compared to standard ERAS patients. A regression analysis confirmed the protective effect of the NutriCatt protocol on severe complications (OR 0.10, 95% CI 0.01–0.56; p = 0.009). Conclusions: The NutriCatt protocol improves clinical outcomes in elderly patients and should be recommended in ERAS colorectal surgery.
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Rinninella et al. (2021) conducted a cohort in Colorectal surgery in ERAS program (n=302). NutriCatt protocol + ERAS vs. Standard ERAS was evaluated on Severe complications (OR 0.10, 95% CI 0.01-0.56, p=0.009). The NutriCatt protocol significantly reduced severe complications compared to standard ERAS in elderly patients undergoing colorectal surgery (OR 0.10; 95% CI 0.01-0.56; p=0.009).
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