Delayed postoperative diet is associated with a greater incidence of prolonged postoperative ileus and longer stay in hospital for patients undergoing gastrointestinal surgery

Rees, Joanna; Bobridge, Kelly; Cash, Catherine; Lyons‐Wall, Philippa; Allan, Rebecca; Coombes, Jacqui

doi:10.1111/1747-0080.12369

Cited by 11 publications

(7 citation statements)

References 25 publications

(134 reference statements)

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“…Of all POI cases, 28.2% (77/273) met the definition of SPOI: 18.2% (14) were hip procedures, 20.8% (16) were knee procedures, 54.5% (42) were spine procedures, and 6.5% (5) were other orthopedic procedures (Fig. 1).…”

Section: Resultsmentioning

confidence: 99%

“…This study was retrospective, and delayed feeding was one of our criteria for SPOI, and so whether there is a causal link cannot be established. However, early post-operative feeding has been found to decrease the rates of ileus, and studies evaluating more aggressive refeeding in elective orthopedic patients should be undertaken [3, 6, 16]. Regardless, slow refeeding is an easy-to-identify red flag for SPOI.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and Risk of Severe Ileus after Orthopedic Surgery: A Case-Control Study

Mandl

Sasaki

Yang

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Post-operative ileus (POI) is common and can be associated with significant morbidity. Questions/Purposes: We aimed to identify the incidence of and risk factors associated with severe postoperative ileus (SPOI) after elective orthopedic surgery. Methods: We conducted a retrospective case-control study of patients undergoing elective orthopedic procedures at a single musculoskeletal specialty hospital. SPOI cases matched 1:2 to non-POI controls. International Classification of Diseases, Ninth Revision (ICD-9), codes were used to identify patients who were coded as having an episode of POI. After chart review, a subset was classified as clinical SPOI cases, based on set criteria. Regression models were constructed to identify variables associated with SPOI. Results: Of 273 POI cases, 77 (28.2%) were classified as SPOI. Overall rates of SPOI were 2.74/1000 orthopedic discharges, with SPOI most common in spine surgeries (9.07/1000 spine procedure discharges). Hypothesis-generating multivariable conditional logistic regression suggested that, for hip and knee cases, not being on a full diet by post-operative day (POD) 2 posed an increased risk of SPOI. For spine cases, not being on a full diet on POD 2 and longer surgery times were associated with risk of SPOI. Conclusions: In this retrospective case-control study, patients undergoing elective orthopedic procedures who had not progressed to full diet by POD 2 and spine patients with longer operative times were most at risk for SPOI. These data can be used clinically by peri-operative physicians to stratify patients according to risk.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Incidence and Risk of Severe Ileus after Orthopedic Surgery: A Case-Control Study

Mandl

Sasaki

Yang

et al. 2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

View full text Add to dashboard Cite

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“…The dietary principles were stated in each diet category. A survey [ 10 ] revealed that many patients knew what they could not eat during their hospital stay, but what puzzled them was the food suitable for eating. Therefore, in each food category, we not only listed foods that were restricted but also foods that were suitable for eating ( Figure 1 ).…”

Section: Design Of Perioperative Health Education On a Mobile Platformmentioning

confidence: 99%

A WeChat-Based Mobile Platform for Perioperative Health Education for Gastrointestinal Surgery

Liu

Cheng

et al. 2021

Emergency Medicine International

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Appropriately instructing and guiding patients before and after surgery is essential for their successful recovery. In recent years, however, the development of the enhanced recovery after surgery (ERAS) protocol has restricted the opportunity for healthcare professionals to spend time with their patients before and after surgery because of efficiency-driven, shortened hospital stay. Here, we embedded health education information of the perioperative period for gastrointestinal surgery on a WeChat-based mobile platform and evaluated the platform through medical staff evaluation, patient volunteer evaluation, and quantitative grading rubric. Clinicians and nurses believed that the mobile platform was attractively designed and easy to navigate, valuable, and adequate for patient health education. The content of health education was embedded into the WeChat-based mobile platform, thereby allowing patients and caregivers to access information at their own pace and enable repeat reading.

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“…A wide variety of cutoff times and criteria have been used by studies to determine PPOI; however, 8-32% of patients suffer from PPOI following surgery. [4][5][6][7][8][9][10][11][12][13] PPOI is known to burden both patients and the health care system. Numerous studies have reported that patients with PPOI are prone to develop postoperative complications 4,9,13 that can lead to negative outcomes such as a prolonged length of stay [9][10][11] , increased reoperation rate and readmission rate 6,9,11,14 , and increased mortality rate.…”

Section: Introductionmentioning

confidence: 99%

Factors Predicting Prolonged Postoperative Ileus in Patients Undergoing Major Gastrointestinal Surgery

Banyong

Chanruangvanich²,

Thosingha³

et al. 2022

Siriraj Med J

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Objective: This study aimed to investigate the rate of prolonged postoperative ileus (PPOI) and its predictive factors focusing on age, body mass index, smoking status, postoperative mobilization, and preoperative anxiety and depression among patients undergoing major gastrointestinal surgery.Materials and Methods: This prospective observational study included patients who underwent elective major gastrointestinal surgery in a super tertiary hospital in Thailand. The data were collected using a uniform case record form including the Hospital Anxiety and Depression Scale and Fagerstrom Test for Nicotine Dependence. PPOI was defined using criteria of Vather et al. (2013). Predictive factors for PPOI were determined by multivariate analysis.Results: A total of 123 patients were enrolled, with an average age of 59.8 ± 12.7 years. The most common indication for surgery was gastrointestinal malignancy (96 patients, 78%), followed by an open approach (75 patients, 61%) and a combined general and epidural anesthesia (58 patients, 47%). Approximately 30% of patients had a history of smoking. Preoperative anxiety and depression were equally found in nine patients (7%). Twenty-seven patients (22%) experienced PPOI. The significant predictive factors of PPOI were having preoperative anxiety (OR = 6.26, 95% CI = 1.22–44.41, p = 0.046) and being unable to ambulate on postoperative day 1 (OR = 3.26, 95% CI = 1.25–8.50, p = 0.015).Conclusion: Preoperative anxiety and delayed postoperative ambulation were two predictors for PPOI in this study. Some interventions to reduce preoperative anxiety and encourage early postoperative ambulation should be considered in patients undergoing major elective gastrointestinal surgery.

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Delayed postoperative diet is associated with a greater incidence of prolonged postoperative ileus and longer stay in hospital for patients undergoing gastrointestinal surgery

Cited by 11 publications

References 25 publications

Incidence and Risk of Severe Ileus after Orthopedic Surgery: A Case-Control Study

Incidence and Risk of Severe Ileus after Orthopedic Surgery: A Case-Control Study

A WeChat-Based Mobile Platform for Perioperative Health Education for Gastrointestinal Surgery

Factors Predicting Prolonged Postoperative Ileus in Patients Undergoing Major Gastrointestinal Surgery

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