Authors (including presenting author) :
Ho CW(1), Li YT(2), Lee LK(1), Lee SPP(2)
Affiliation :
(1) Dietetic Department, Tseng Kwan O Hospital (2) Dietetic Department, United Christian Hospital
Objectives :
Enhanced Recovery After Surgery (ERAS) is firmly established as a global surgical quality improvement initiative that results in both clinical improvements and cost benefits to the healthcare system. Research has shown higher BMI is related to greater risk of mechanical implant failure, prosthesis dislocation and component malposition. This is a prospective study from April 2021 to March 2022 to examine service coverage and impact of nutrition support and counseling on relevant outcomes among patients under ERAS for orthopedic.
Methodology :
Patients' recruitment was protocol-driven based on BMI ≥ 27.5 or poor glycemic control or malnourished patient using Malnutrition Universal Screening Tool score and/or Malnutrition screening tool ≥3, and scheduled for elective hip and knee arthroplasty surgeries, were referred for nutrition therapy. Patient would be assessed during pre-, peri- and post-operation according to protocol. Parameters such as estimated intakes, body weight, body fat percentage, muscle mass, waist circumference were measured at different time points as mentioned above.
Result & Outcome :
A total of 287 patients were referred and 247 of them completed knee arthroplasty. The average length of intervention was 149 days. There were 155 patients with complete set of data including pre-and post-data comparison. Body weight was significantly reduced from 73.6kg to 72.4kg (p=0.000), body fat percentage was also significantly reduced from 42.9% to 41.0% (p=0.000), while there was no loss in muscle mass (median difference: 0kg). Waist circumference was also demonstrated to significantly decrease from 102.5cm to 99cm (p=0.000). Estimated energy intake was significantly reduced from 1500kcal/day to 1355kcal/day (p=0.000) after dietary interventions and estimated protein intake was also significantly decreased from 55g/day to 52g/day (p=0.023). To conclude, body weight and fat as well as waist circumferences were successfully reduced prior to surgery. Muscle mass on the contrary was preserved during the program. The improvement after nutrition intervention would positively impact on surgery outcomes and glycemic control for patients undergoing hip and/or arthroplasty.
