Dietitian-led supportive care for postoperative nutritional achievement: A secondary analysis of a Randomized Controlled Trial

Abstract

Sufficient postoperative dietary intake is crucial for promoting wound healing and ensuring better surgical outcomes. This study aimed to determine the postoperative nutritional achievement and predictors of postoperative dietary intake among gynecologic cancer patients. A total of 118 participants were included in this secondary analysis. Postoperative dietary data were pooled and re-classified into early postoperative dietary intake achievement (EDIA) (daily energy intake (DEI) ≥ 75% from the estimated energy requirement (EER)) and delay dietary intake achievement (DDIA) (DEI < 75% EER) There was a significant difference in postoperative changes in weight (p = 0.002), muscle mass (p = 0.018), and handgrip strength (p = 0.010) between the groups. Postoperative daily energy and protein intake in the EDIA was significantly greater than DDIA from operation day to discharged (p = 0.000 and p = 0.036). Four significant independent postoperative dietary intake predictors were found: preoperative whey protein-infused carbohydrate loading (p = 0.000), postoperative nausea vomiting (p = 0.001), age (p = 0.010), and time to tolerate clear fluid (p = 0.016). The multilinear regression model significantly predicted postoperative dietary intake, F (4,116) = 68.013, p = 0.000, adj. R2 = 0.698. With the recognition of four predictors, the integration of more specific and comprehensive dietitian-led supportive care with individualized nutrition intervention into the multidisciplinary Enhanced Recovery After Surgery approach should be considered to promote functional recovery.