Association between nutrition-focused evidence-based nursing and post-operative nutritional status in patients...

Patients undergoing colorectal cancer surgery are at risk of postoperative nutritional deterioration due to perioperative metabolic stress, inflammation, and transient gastrointestinal dysfunction. Evidence-based, nursing-led nutritional pathways may improve perioperative nutritional surveillance and timely nutrition support.

This retrospective study included 214 adults who underwent elective curative-intent colorectal cancer resection between January 2023 and December 2024. Patients receiving routine perioperative nursing care in 2023 were assigned to the control group (n = 106), whereas those receiving the nutrition-focused evidence-based nursing protocol in 2024 were assigned to the observation group (n = 108). The primary outcomes were change in Nutritional Risk Screening 2002 (NRS-2002) score and postoperative nutritional risk, defined as NRS-2002 ≥ 3 at postoperative day 7 or immediately before discharge.

Baseline characteristics were comparable between groups. The observation group had lower postoperative NRS-2002 scores and smaller ΔNRS-2002 than the control group (both P < 0.001). Postoperative nutritional risk was also lower in the observation group (44.4% vs. 67.0%, P = 0.001). After multivariable adjustment, the observation group remained associated with lower odds of postoperative nutritional risk (adjusted odds ratio = 0.17, 95% confidence interval: 0.08-0.36; P < 0.001). Secondary findings showed less weight loss, smaller declines in albumin and prealbumin, lower discharge C-reactive protein, earlier feeding recovery, shorter postoperative hospital stay, fewer overall complications, and fewer nutrition-support-related safety events.

A nutrition-focused evidence-based nursing protocol was associated with more favorable postoperative nutritional risk status assessed by NRS-2002, as well as selected short-term recovery- and safety-related outcomes after colorectal cancer surgery. These findings should be interpreted as associative and require confirmation in prospective studies.