Parenteral nutrition after major elective upper gastrointestinal surgery: A descriptive cohort study

Patients undergoing major upper gastrointestinal surgery are at high nutrition risk, with central or peripheral parenteral nutrition an option when oral or enteral nutrition are not possible. We aimed to determine the number of patients who were indicated but did not receive parenteral nutrition according to an international consensus guideline following major upper gastrointestinal surgery.

A retrospective audit of patients undergoing major upper gastrointestinal surgery was conducted at a single center between August 13, 2021, and December 29, 2023. Included patients were considered at nutrition risk. Data were extracted on baseline characteristics, nutrition therapy and adequacy of nutrition intake. Data were analyzed using descriptive statistics and were presented as median or mean. The primary outcome was the number of patients who were indicated but did not receive parenteral nutrition according to an international consensus guideline.

A total of 100 patients were included (55 [55%] male; age 68 [59-78] years, and body mass index 25.0 [22.5-29.0] kg/m²). Out of 100 patients, parenteral nutrition was indicated in 42 (42%). Among those who met criteria, 3 of 42 (7%) received parenteral nutrition, whereas 39 of 42 (93%) did not. The percentage of energy and protein adequacy at day 7 was 53 [41-68] % and 58 [39-74] %, respectively.

Most patients who were indicated to did not receive parenteral nutrition within 7 days postsurgery in a single center in Australia. The potential indicators for use of parenteral nutrition via central or peripheral delivery should be further explored.