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全靜脈營養與重大腹部手術病患術後住院日數的相關因子探討

The Effect of Total Parenteral Nutrition and Other Factors on the Length of Postoperative Hospital Stay after Major Gastrointestinal Surgery

摘要


We evaluated the effect of total parenteral nutrition and other factors on the length of hospital stay (LOS) after a major gastrointestinal surgery. In a retrospective study of 100 adult patients in Hsin-Chu General Hospital, the effect of various factors on LOS-suoh as age, site of surgery, the presence or absence of malignancy, preoperative nutrition risk index (NRI), postoperative complications, use of total parenteral nutrition (TPN) support, the day of beginning enteral feeding after surgery, and the period of inadequate intake from enteral nutrition were determined. The results revealed that age, site of surgery, and malignancy had no effect on LOS. However, the LOS was markedly prolonged in patients with compared to those without postoperative complications (35.2±22.2 vs. 15.4±5.9 days) and postoperative TPN support compared with those who did not (31.1±21.6 vs. 16.0±7.6 days). Patients were then grouped into those who received (n=50) and who did not receive (n=50) TPN support. A significantly extended LOS was found for patients with preoperative malnutrition (n=17; 29.7±17.9 days) or postoperative complications (n=30; 39.8±23.3 days) or both (n=12; 34.1±18.9 days) in the TPN support group. The LOS significantly correlated with the NRI (r=-0.295, p <0.01), the day of beginning enteral feeding after surgery (r=0.536, p<0.01), and the period of inadequate intake from enteral nutrition (r=0.897, p<0.01). The period of inadequate intake from enteral nutrition, the days of beginning enteral feeding after surgery and use of TPN support account for most of the variation (R^2 = 0.824) of the effect on LOS in a stepwise regression model. Gastrointestinal dysfunction resulting from postoperative complications was the main cause of prolonged LOS. Therefore, it is recommended that nutrition screening should be undertaken during hospital admission to determine nutritional risk, and dietary assessment should be carried out after surgery.

並列摘要


We evaluated the effect of total parenteral nutrition and other factors on the length of hospital stay (LOS) after a major gastrointestinal surgery. In a retrospective study of 100 adult patients in Hsin-Chu General Hospital, the effect of various factors on LOS-suoh as age, site of surgery, the presence or absence of malignancy, preoperative nutrition risk index (NRI), postoperative complications, use of total parenteral nutrition (TPN) support, the day of beginning enteral feeding after surgery, and the period of inadequate intake from enteral nutrition were determined. The results revealed that age, site of surgery, and malignancy had no effect on LOS. However, the LOS was markedly prolonged in patients with compared to those without postoperative complications (35.2±22.2 vs. 15.4±5.9 days) and postoperative TPN support compared with those who did not (31.1±21.6 vs. 16.0±7.6 days). Patients were then grouped into those who received (n=50) and who did not receive (n=50) TPN support. A significantly extended LOS was found for patients with preoperative malnutrition (n=17; 29.7±17.9 days) or postoperative complications (n=30; 39.8±23.3 days) or both (n=12; 34.1±18.9 days) in the TPN support group. The LOS significantly correlated with the NRI (r=-0.295, p <0.01), the day of beginning enteral feeding after surgery (r=0.536, p<0.01), and the period of inadequate intake from enteral nutrition (r=0.897, p<0.01). The period of inadequate intake from enteral nutrition, the days of beginning enteral feeding after surgery and use of TPN support account for most of the variation (R^2 = 0.824) of the effect on LOS in a stepwise regression model. Gastrointestinal dysfunction resulting from postoperative complications was the main cause of prolonged LOS. Therefore, it is recommended that nutrition screening should be undertaken during hospital admission to determine nutritional risk, and dietary assessment should be carried out after surgery.

被引用紀錄


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