Tackling malnutrition among US surgical patients can slash readmission rates in half: study

03 Jul 2018 --- Implementing a nutrition care program for malnourished surgical patients can achieve a reduction in readmission rates of nearly 50 percent, according to new data from Advocate Health Care and Abbott, pointing to the need for guidelines on improving nutrition before and after surgery for better patient outcomes. For surgical patients, the focus has for decades been on making sure patients do not consume any food or drinks in the hours leading up to the surgery. Yet, one in three patients are malnourished or at risk of malnutrition when they're admitted to the hospital, and many are unaware of it. 

New research from Advocate Health Care, supported by US health care company Abbott, shows that this lack of nutrition could have major health implications on patients' surgical outcomes.

As part of a real-world evidence study, Advocate Health Care implemented a nutrition care program at four of its Chicago area hospitals to help ensure patients are nourished during their hospital stay and post-discharge. 

The data, published in The Journal of Parenteral and Enteral Nutrition, looked at the role of nutrition care for at risk or malnourished medical and surgical patients. Researchers found that more than 300 malnourished surgical patients who received nutrition care had reduced hospital readmission rates by nearly 50 percent after 30 days of being discharged, as well as a reduction in the average length of stay by 2.7 days.

Suela Sulo, Ph.D., Researcher at Abbott and one of the study authors, tells NutritionInsight that these findings are meaningful because they highlight how proper nutrition protocols can help a significant number of people recover faster from their surgeries and get back to their everyday lives. Moreover, they show that addressing nutrition can also help the financial health of the nation’s healthcare system. 

“The study found that reducing readmissions and shortening the length of hospital stays led to an overall cost saving of US$3,800 per patient,” she notes.

“Driven by a commitment to achieve better outcomes at lower cost, our health system's embrace of a relatively modest nutrition care program could have wide-reaching implications for surgical patients across the country,” says Krishnan Sriram, M.D., Tele-Intensivist at Advocate Health Care and principal investigator of the study. “By prioritizing nutrition, care providers can significantly enhance the recovery process and deliver better value for patients and their families.”

Malnutrition occurs when the body doesn't get the nutrients it needs, but often goes undiagnosed because it can be invisible to the eye in both underweight and overweight individuals. 

Because surgeries take a large toll on a patient's body, addressing malnutrition can help set patients up for a more successful recovery. 

“Research shows when we screen, feed and follow patients' nutritional status in the hospital and after they are discharged, we are helping them have the best chances of a successful recovery,” Sulo says. “Without proper nutrition protocols, malnourished patients undergoing surgery can experience delayed wound healing, surgical site infections, a longer length of stay and higher rates of hospital readmission.”
 
“The good news is surgical guidelines are focusing on the importance of nutrition in the hospital, prompting hospitals to start reevaluating their surgical protocols,” she notes. 

At a recent conference, a group of international experts from the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative developed new guidelines for surgery-related nutrition. These guidelines call for routine pre-surgery nutrition screening to identify patients in need of nutrition optimization, and to restart nutrition supplementation immediately after surgery and continue to incorporate it as part of their post-operative care. 

“By studying the role of nutrition in aging and disease management, Abbott is helping adults live more active, healthier and longer lives. We've conducted more than 200 published studies to understand the impact of nutrition on aging and chronic disease. Abbott uses its science to develop new nutrition products that address adults’ evolving health needs. As a society, we need to take nutrition more seriously and make it a priority to help patients achieve the best possible health outcomes,” she concludes. 

By Lucy Gunn