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Post-operative nutritional practice in emergency laparotomy.

Jannick Brander Hansen1,2,3, Bente Hegstad1,2, Nadia Boujida1,2

  • 1Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospital - Herlev and Gentofte Hospital.

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Post-operative nutrition after emergency laparotomy is challenging. Current practices for nutritional support in these patients often deviate from established guidelines, highlighting a need for tailored approaches.

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Area of Science:

  • Surgical Nutrition
  • Gastroenterology
  • Clinical Practice Guidelines

Background:

  • Post-operative nutritional management after emergency abdominal surgery presents significant challenges.
  • Evidence-based nutritional strategies for this patient group require integration into clinical guidelines.
  • Current nutritional practices following emergency laparotomy need evaluation against existing recommendations.

Purpose of the Study:

  • To describe current nutritional practices in patients undergoing emergency laparotomy at a university hospital.
  • To compare the observed nutritional management with current evidence-based guidelines.
  • To identify discrepancies between routine care and recommended nutritional support.

Main Methods:

  • A single-center, retrospective cohort study was conducted.
  • Included consecutive patients undergoing emergency laparotomy between August 2021 and August 2022.
  • Nutritional data were assessed daily from post-operative day 1 to 30, excluding transferred patients.

Main Results:

  • 231 patients were analyzed; 51.1% were male, median age 71 years.
  • Bowel obstruction was the most common diagnosis (62.3%).
  • Only 48.9% achieved oral intake on post-operative day 1; 28.6% received parenteral nutrition, initiated a median of 4 days post-surgery.

Conclusions:

  • Early oral intake was achieved in only half of the emergency laparotomy patients.
  • Routine post-operative nutritional practices frequently diverge from current guidelines.
  • Emergency laparotomy patients require distinct nutritional considerations compared to elective surgical cases.