Parental nutrition in emergency surgery: A multicentre cross-sectional study

Area of Science:

• Surgical nutrition
• Clinical outcomes research
• Patient recovery pathways

Background:

• Emergency general surgical patients face significant malnutrition risks.
• Parenteral nutrition (PN) is a critical intervention for these patients when oral intake is not feasible.
• Timely initiation of PN is crucial for effective patient recovery.

Purpose of the Study:

• To assess the timing of decisions regarding PN initiation in emergency general surgical patients.
• To evaluate the outcomes associated with PN delivery in this patient cohort.
• To identify factors influencing the PN decision-making process.

Main Methods:

• A retrospective study of 125 adult emergency general surgical patients receiving PN across eight UK hospitals.
• Data collected included patient demographics, nutritional status, PN decision dates, and PN-related complications.
• Statistical analysis, including chi-squared tests, was used to investigate associations and determine significance (p < 0.05).

Main Results:

• The median time to decision for PN was 5 days post-admission.
• Patients received PN for an average of 11 days.
• Eighty-five percent of patients experienced complications, most commonly phosphate abnormalities (54%); only altered blood glucose correlated with delayed PN initiation.

Conclusions:

• Significant delays exist in the decision-making process for initiating PN in acutely ill surgical patients.
• Once initiated, the PN pathway appears relatively efficient.
• High incidences of electrolyte abnormalities are prevalent in this patient population receiving PN.