Vol 3, No 3 (2001)
Published online: 2002-02-08
Nutrition therapy in the early postoperative period after extensive operations in patients over 65
Chirurgia Polska 2001;3(3):127-134.
Abstract
Background: Old patients are becoming more and more frequent subjects of surgical interventions and the kind and duration of the performed operations are usually age-independent. The aim of the study was to evaluate the results of nutritional therapy in surgical patients over 65 in comparison to groups of younger patients.
Material and methods: Two comparable groups of 25 patients were evaluated. The sex, grade of the body weight loss, basic diseases, kind of the surgery, indications, type and duration of the nutritional therapy were similar in both groups.
The following factors were analysed: advancement of preoperative malnutrition, actual energy expenditure, energy and protein intake, amount of the blood substitutes, complications of surgery and parenteral nutrition, relation between the percentage of the body weight loss and complication occurrence.
Results: The energy intake in the elderly (2139 kcal/d) was similar to the actual energy expenditure (2755 kcal/d). Mean nitrogen intake was 0.2 gN/kg/d. The group of older patients required a higher number of the transfused blood and plasma units (FFP transfusions: 16 U vs. 13.6 U, RBCC 4.9 U vs. 3.6 U respectively). The prevalence of the postoperative complications was more frequent in the group of older patients, especially concerning urinary tract infections, pneumonia (p < 0.01), disturbances of the cardiovascular and respiratory system (p < 0.05). The loss of the body weight of more than 10% was noticed in all deceased patients and in 80% of cases with three or more postoperative complications.
Conclusions: The body weight loss, especially exceeding 10%, is a simple and effective parameter in prognosis of complication prevalence in the elderly. Effective treatment of the postoperative complications in the elderly is possible due to application of an intensive nutritional therapy.
Material and methods: Two comparable groups of 25 patients were evaluated. The sex, grade of the body weight loss, basic diseases, kind of the surgery, indications, type and duration of the nutritional therapy were similar in both groups.
The following factors were analysed: advancement of preoperative malnutrition, actual energy expenditure, energy and protein intake, amount of the blood substitutes, complications of surgery and parenteral nutrition, relation between the percentage of the body weight loss and complication occurrence.
Results: The energy intake in the elderly (2139 kcal/d) was similar to the actual energy expenditure (2755 kcal/d). Mean nitrogen intake was 0.2 gN/kg/d. The group of older patients required a higher number of the transfused blood and plasma units (FFP transfusions: 16 U vs. 13.6 U, RBCC 4.9 U vs. 3.6 U respectively). The prevalence of the postoperative complications was more frequent in the group of older patients, especially concerning urinary tract infections, pneumonia (p < 0.01), disturbances of the cardiovascular and respiratory system (p < 0.05). The loss of the body weight of more than 10% was noticed in all deceased patients and in 80% of cases with three or more postoperative complications.
Conclusions: The body weight loss, especially exceeding 10%, is a simple and effective parameter in prognosis of complication prevalence in the elderly. Effective treatment of the postoperative complications in the elderly is possible due to application of an intensive nutritional therapy.
Keywords: parenteral nutritionresective surgeryold age
