Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Wong HMC (1), Chang KYS (1), Tam HYG (1), Choy SYE (1), Leung HTS (1), Dr. Chu C (2)
Affiliation :
(1) Dietitian, Dietetic Department, QEH
(2) Department of Surgery, QEH
Introduction :
Malnutrition is frequently associated with surgical illness due to increased metabolic demands, inadequate nutrition intake, or nutrient loss. Malnutrition risk will be a concern in patients diagnosed with Gastroenterological cancer. Malnutrition before surgery may lead to ongoing energy deficits, which may increase infectious complication risks and undesirable clinical outcomes after. Unintentional weight loss (UWL) is one of the crucial predictors of malnutrition, thus, UWL should be avoided. One objective of the ERAS program aimed to improve nutritional status in patients undergoing elective surgery before and after surgery.
Objectives :
(1) To identify the prevalence of medium and high malnutrition risks of patients enrolled in the ERAS program before surgery
(2) To investigate the weight change of patients seen by dietitians in the outpatient setting before surgery and on the day of admission for surgery
Methodology :
From October 2022 to October 2023, subjects were enrolled in the ERAS program and assessed by Dietitians to be categorized into low, medium or high malnutrition risks. Body weight were measured on the first day of assessment and on the day of admission prior to surgery.
Result & Outcome :
Results
Out of 233 cases, 181, 44 and 8 cases were categorized into low, medium, high malnutrition risks on the first day of assessment in the outpatient setting respectively. Other data (137 cases) were excluded as patients were not seen before or after surgery or no surgery was done in QEH. Most of the patients demonstrated medium and high malnutrition risks had normal BMI (47%), with a few were underweight (26%), overweight (23%) or obese (4%).
The median body weight of medium risks patients on the admission day for surgery were statistically significantly higher than the first assessment in outpatient before surgery (Z =-2.357, p = 0.018) as per Wilcoxon Signed Ranks Test. The high risk group were able to maintain median body weight.
Conclusion
Approximately one in five cancer patients (22%) were found to have medium or high malnutrition risks. Those with medium and high risks might be able to improve nutritional outcome after Dietitians’ consultation before surgery, this might also improve surgical outcomes.
