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PAM2 ORAL NUTRITIONAL SUPPLEMENTATION CAN IMPROVE POSTOPERATIVE OUTCOMES FOR COLORECTAL SURGERY PATIENTS

      Objectives

      Limited real-world evidence exists regarding the impact early postoperative oral nutritional supplementation (ONS) has on health and economic outcomes of patients following colorectal surgery (CRS). We assessed the association between early ONS use and postoperative outcomes in patients undergoing elective open or laparoscopic CRS over a 7-year timeframe.

      Methods

      A retrospective analysis was conducted of patients undergoing elective open or laparoscopic CRS between 2008–2014 in US hospitals reporting data in the nationwide administrative-financial database - Premier Healthcare Database. Early ONS and non-early ONS were defined as the presence of charges for ONS before and after postoperative day (POD) 3, respectively. The primary outcome was a composite variable of any infectious complications observed. Secondary efficacy outcomes included intensive care unit (ICU) admission after POD 3 and gastrointestinal complications. Falsification outcomes included blood transfusion and myocardial infarction. Propensity score matching in addition to univariate analysis was applied to assemble two comparable patient groups and examine postoperative outcomes differences.

      Results

      In the overall study population, patients receiving early ONS were older with greater comorbidities, more likely to be Medicare beneficiaries with malnutrition than non-early ONS recipients. Following propensity score matching, the data show that infectious complications were significantly lower in early ONS (n=267) versus non-early ONS (n=534) recipients (6.7% vs. 11.8%, P<0.03). Additionally, early-ONS use was associated with significantly reduced rates of pneumonia (P<0.04), ICU admissions (P<0.04), and gastrointestinal complications (P<0.05). There were no significant differences in falsification outcomes.

      Conclusions

      In a well-matched sample of CRS patients, early ONS users experienced reduced infectious complications, pneumonia, ICU admission, and gastrointestinal complications. Observed improvements can lead to reduced hospital costs and overall healthcare expenditure for CRS patients. This data highlights the importance of ONS as a cost-saving intervention. Future research employing prospective study designs are needed to provide additional support for the study findings.