Malnutrition priori a major abdominal surgery is frequent and increases morbidity and mortality. The management of malnutrition has an impact in reducing postoperative complications. However malnutrition is rarely detected and Guidelines infrequently followed. Recovery time and nutritional evaluation in elderly patients are major criteria in their postoperative management. Identifying malnutrition or malnutrition risk is fundamental to its treatment. It is therefore unsurprising that many validated tools for nutrition risk screening and nutrition assessment exist for the clinician to use in assisting with the accurate identification, referral and treatment of patients who are malnourished or at risk of malnutrition. And nutritional management must be adapted and based on this evaluation and evolution of the general status (Guidelines Grade A). A geriatric evaluation based on a screening of preoperative malnutrition should allow a better implementation of the European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines.
Assessing the impact of a geriatric action (Team Mobile Geriatrics, EMG, or if the geriatric facility team when it does not have EMG) on the rate of nutritional support perioperative elderly subjects (≥ 70 years) who underwent a colorectal cancer according to ESPEN recommendations and SFNEP.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SCREENING
Masking
NONE
Enrollment
150
* Multidisciplinary training sessions for malnutrition and malnutrition risk screening, postoperative nutritional procedures according to the ESPEN Guidelines * Preoperative Geriatric evaluation : eligibility criteria, nutritional status, previous history, comorbidities, clinical examination, activities of daily living (ADL) and Instrumental activities of daily living (IADL) * Implementation of an adapted nutritional support based on ESPEN Guidelines
Professeur Marc BONNEFOY
Pierre-Bénite, France
RECRUITINGPerioperative nutritional management
Rate of nutritional support implemented in accordance with current European guidelines (ESPEN)
Time frame: During perioperative period From D-7 before date of hospitalization until discharge from the hospital, up to 30 days
Malnutrition screening
Rate of malnutrition screening procedure
Time frame: During preoperative seven days
Rate of preoperative nutritional management by immunonutrition implemented
Nutritional management by immunonutrition implemented is based on a complete nutritional evaluation
Time frame: During preoperative seven days
Rate of malnourished patients
Rate of malnourished patients is defined by the ESPEN criteria
Time frame: During preoperative seven days
Rate of patients with cachexia
Rate of patients with cachexia is defined by the French National Authority for Health (HAS) criteria
Time frame: Seventh day preoperative
Postoperative complications
Rate and type of postoperative complications (Grade I, II et IIIa of Dindo classification)
Time frame: Postoperative follow-up until discharge from hospital, up to 30 days
Rate of postoperative nutritional management implemented
Nutritional management implemented is based on the ESPEN guidelines
Time frame: Postoperative follow-up until discharge from hospital, up to 30 days
Evolution of the activities of daily living
Variations of Activities of daily living (ADL) and Instrumental activities of daily living (IADL) scores
Time frame: During preoperative seven days and postoperative follow-up until discharge from hospital, up to 30 days
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