Malnutrition results in increased length of stay, increased post-surgical complications and increased mortality (1,2). Of all cancers, upper gastro-intestinal (GI) cancer group have the highest incidence of malnutrition. The aim of this study was to observe nutritional parameters of patients undergoing surgery for upper GI cancer at Cabrini Malvern.
A retrospective study reviewing 30 medical histories of patients admitted to Cabrini for upper GI surgery over the previous 12 months was undertaken. Information was collected on type of cancer, date of diagnosis, date and type of surgery and length of hospital stay, along with patients’ weight pre- and post-surgery and any reported pre-surgery loss of weight. Requirements for neo-adjuvant chemotherapy or radiotherapy were also recorded.
60% of patients who had upper GI surgery for cancer had neo-adjuvant chemotherapy. All of these patients experienced significant loss of weight prior to surgery (>5% of body weight over approximately 3 months) however only 43% of patients were referred to see a Dietitian during their admission for chemotherapy (either as an inpatient or in day oncology). Weight loss continued during admission for surgery on average 4% of body weight for all patients. Only 7 out of 30 patients received enteral nutrition during admission. There was a positive correlation between degree of weight loss pre-surgery and increased length of hospital admission for surgery (r=0.7). This study highlighted the need for early identification of patients at high risk of malnutrition, through malnutrition screening (as an inpatient or outpatient) and timely referral to a Dietitian to assist with minimising loss of weight pre-surgery and reducing length of stay.