Early and sufficient feeding reduces length of stay and charges in surgical patients

Leigh A Neumayer, Randall J. Smout, Howard G S Horn, Susan D. Horn

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background. The role of perioperative nutrition in surgical patients remains controversial. We performed a Clinical Practice Improvement (CPI) study that, while controlling for severity of illness, explored the relationship between the timing and amount of parenteral or enteral nutrition, with two outcomes: length of stay (LOS) and total charges in patients undergoing open intestinal operations. Materials and methods. A CPI study was conducted at eight hospitals to determine which process steps were associated with shorter LOS and lower charges. Hospital charts were abstracted for over 800 components of detailed patient, process, and outcome measures. Severity of illness was measured multiple times during the stay using the Comprehensive Severity Index, a disease-specific physiologic severity measurement instrument. Data on 1007 patients undergoing intestinal operations, 183 of whom received nutritional support, were then analyzed using multiple regression procedures. Early (within 48 h of surgery) and sufficient (60% of protein and calorie goals) nutrition, patient variables, and a severity of illness measure were included as independent variables and LOS and hospital charges were used as dependent variables. Results. Mean patient age was 58 years. After controlling for severity of illness, patients who received early and sufficient nutrition had significantly shorter LOS (11.9 days) and lower charges ($34,602) than patients who received early (13.3; $36,452), sufficient (14.6, $39,883), or neither early nor sufficient (14.8, $38,578) (P ≤ 0.0001 for early and sufficient versus all other groups). Conclusions. CPI methodology provides a detailed view of the actual relationship between the timing and the amount of nutrition with LOS and hospital charge outcomes.

Original languageEnglish (US)
Pages (from-to)73-77
Number of pages5
JournalJournal of Surgical Research
Volume95
Issue number1
DOIs
StatePublished - 2001
Externally publishedYes

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Length of Stay
Hospital Charges
Process Assessment (Health Care)
Nutritional Support
Parenteral Nutrition
Enteral Nutrition
Outcome Assessment (Health Care)
Proteins

ASJC Scopus subject areas

  • Surgery

Cite this

Early and sufficient feeding reduces length of stay and charges in surgical patients. / Neumayer, Leigh A; Smout, Randall J.; Horn, Howard G S; Horn, Susan D.

In: Journal of Surgical Research, Vol. 95, No. 1, 2001, p. 73-77.

Research output: Contribution to journalArticle

Neumayer, Leigh A ; Smout, Randall J. ; Horn, Howard G S ; Horn, Susan D. / Early and sufficient feeding reduces length of stay and charges in surgical patients. In: Journal of Surgical Research. 2001 ; Vol. 95, No. 1. pp. 73-77.
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