Risco nutricional e diagnóstico de desnutrição em cirurgia colorretal: comparação entre indivíduos de realimentação precoce vs. convencional

Abstract

Introduction: Malnourished patients have a greater response to surgical trauma, with more severe clinical repercussions. Nutritional screening upon admission and subsequent nutritional assessment are essential for monitoring and interventions, contributing to better outcomes, reduction of complications, length of hospital stay and hospital costs. Early oral refeeding is also a fundamental strategy in postoperative recovery, but it is still underutilized. Protocols that promote the resumption of feeding in the first 24 hours are crucial to optimize patient recovery. Objective: To assess the presence of nutritional risk and the diagnosis of malnutrition in patients who underwent or did not undergo early refeeding in the postoperative period of colorectal surgeries. Methods: Cross-sectional study nested in a randomized, phase 3, parallel, superiority clinical trial. Conducted in adult and elderly individuals of both sexes, in the preoperative period of colorectal surgery, at the Professor Alberto University Hospital, in Maceió/AL, from June 2023 to December 2024. Results: The sample consisted of 68 patients, 66 of whom were considered valid for statistical analysis, with a mean age of 57.2 ± 13.4 years. Of these, 56.1% (n=37) were oncology patients. At baseline, 47.1% of the intervention group and 52.9% of the control group were at nutritional risk during screening. Of the patients who underwent early oral refeeding, 50% were already diagnosed with malnutrition, and 47.4% remained in this condition throughout the follow-up. A significant increase in the frequency of eutrophy was identified in 45.5% of patients with excess weight at baseline, becoming eutrophic on the 30th POD (p=0.030). Conclusion: Significant frequencies of patients undergoing colorectal surgeries with nutritional risk and malnutrition were observed, with a significant change in the frequency of eutrophic patients at the end of the period evaluated, where patients who were overweight began to present eutrophy. The role of the nutritionist is reinforced as a sine qua non condition for optimal nutritional monitoring in the perioperative period, highlighting their role in the recovery and adequacy of the nutritional status of patients.