Preoperative Nutritional Status and Risk Factors Associated with Delayed Discharge in Geriatric Patients Undergoing...

Area of Science:

• Geriatric Oncology
• Surgical Nutrition
• Gastrointestinal Surgery

Background:

• Preoperative malnutrition is a significant predictor of adverse outcomes in gastric cancer patients.
• Understanding malnutrition prevalence and its impact on recovery is crucial for optimizing care in elderly patients undergoing gastrectomy.

Purpose of the Study:

• To determine the prevalence of malnutrition in geriatric patients undergoing gastrectomy for gastric cancer.
• To evaluate perioperative nutritional support strategies.
• To identify risk factors contributing to delayed hospital discharge in this patient population.

Main Methods:

• Retrospective analysis of 783 gastric cancer patients (age ≥ 65) who underwent gastrectomy.
• Data collection included demographics, medical history, surgical factors, and nutritional management.
• Assessment of postoperative complications using Clavien-Dindo grading and calculation of the prognostic nutritional index (PNI).

Main Results:

• Malnutrition was prevalent in 31.3% of patients, associated with lower albumin, prealbumin, and hemoglobin levels.
• Malnourished patients received more preoperative total parenteral nutrition but less postoperative total nutrient admixture.
• Significant risk factors for delayed discharge included age > 70, operation time > 180 min, PNI < 44.5, and postoperative complications.

Conclusions:

• Malnutrition is common in elderly patients undergoing gastrectomy and is linked to increased postoperative complications.
• Age, surgical duration, PNI, and complications are key factors prolonging hospital stay.
• Targeted nutritional interventions and management strategies are essential for improving outcomes and reducing hospital stay in at-risk elderly gastric cancer patients.