2019 Volume 1 Issue 4 Pages 242-249
Background: Our hospital has had a full-time dietician on staff since 2015, but the impact of having a full-time dietician as a part of the postoperative care team has not been studied well. We retrospectively investigated short-term outcomes in patients who underwent pancreatoduodenectomy before and after having a full-time staff dietitian on staff.
Methods: We retrospectively investigated nutritional status, interventions, and postoperative morbidities in patients who underwent pancreaticoduodenectomy between 2013 and 2016. The patients were divided into 2 groups: before having a dietitian as a full-time staff member in the ward (pre group) and after (post group). We investigated nutrition intake (parenteral nutrition (PN), enteral nutrition, and total caloric intake), preoperative and postoperative nutritional status, duration of PN, and postoperative morbidities including catheter-related blood stream infection (CRBSI). Nutritional counseling was provided at the requested of the physician in the pre group but was provided regularly in the post group.
Results: There were 187 patients in the pre group and 230 in the post group. The post group received significantly less PN, more enteral nutrition, and more total calories than the pre group from postoperative days 7 to 14. Although there were no significant differences in preoperative nutritional status between the 2 groups, the prealbumin level tended to be higher in the post group than the pre group on postoperative day 14 (p=0.0502). The median duration of PN was shorter in the post group than the pre group (median 10 days vs. 12 days, respectively; p=0.001). The incidence of probable CRBSI was significantly lower in the post group than the pre group (1.3% vs. 4.8%, respectively; p=0.03), although incidence density differed between the groups (1.05 vs. 3.26/1000 line days, respectively).
Conclusions: Having a full-time dietitian in the ward increased total energy intake and prealbumin level on postoperative day 14, and reduced the incidence of probable CRBSI without increasing postoperative morbidities among patients who underwent pancreaticoduodenectomy.
