Pre- and Post-Operative Nutrition Assessment in Patients with Colon Cancer Undergoing Ileostomy.

INTRODUCTION: Patients undergoing ileostomy surgery often experience electrolyte disturbances and dehydration, especially during the first post-operative period. Recently, research has also begun on how the newly constructed ileostomy affects the patient's nutritional status. AIM: The aim of the present pilot study was to assess the nutritional status of patients before and after the construction of the ileostomy as well as nutrition-related factors. MATERIAL AND METHOD: This was a pilot study. The sample consisted of 13 adult patients diagnosed with colorectal or colon cancer who underwent scheduled ileostomy surgery. The evaluation tool used was "Original Full Mini Nutritional Assessment (MNA)". Patients underwent nutritional assessment before the surgery (time 0), on the 7th post-operative day (time 1), and on the 20th post-operative day (time 2). The statistical significance level was set at p < 0.05. RESULTS: All patients had a drop in MNA score on the 7th and 20th post-operative days. Factors associated with MNA were weight loss, mobility, body mass index (BMI), number of full meals consumed per day, portions of fruits and vegetables consumed per day, and mid-arm circumference, p < 0.05, respectively. Pre-operatively, 38.5%, of patients had severe weight loss (>3 kg), 23% moderate weight loss and 38.5% minimal weight loss. Pre-operatively, 92.3% of participants were able to move on their own and 69.2% on the 20th post-operatively day. Furthermore, BMI >23 kg/m2 had 84.6% of participants pre-operatively and 30.8% on the 20th post-operative day. In terms of portions of fruits and vegetables consumed per day, 30.8% of patients consumed at least 2 times, pre-operatively and no one (0%) on the 20th post-operative day. Moreover, pre-operatively all participants (100%) had arm circumference >22 cm while on the 20th post-operative day, only 38.5% of participants had arm circumference >22 cm. CONCLUSIONS: In the first 20 days after the construction of an ileostomy, the nutritional status of the patients is significantly affected. Decreased patient nutrition in both quantity and ingredients and reduced fluid intake appear to adversely affect the patient's nutritional status.

Frailty in elderly ICU patients in Greece: a prospective, observational study.

BACKGROUND: Of particular interest is the study of frailty syndrome in older patients in recent years. This syndrome is characterized by weight loss and muscle mass, a change in eating habits, movement and endurance, and a decline in cognitive function. The purpose of the study was the prevalence of frailty syndrome in subjects aged 65 years who were hospitalized in an intensive care unit (ICU) in Greece. METHODS: This is a prospective, observational study. The study sample consisted of families or carers of 36 patients over 65 years of age. The study was conducted in a General Hospital in Greece, over a period of 1 year. The Clinical Frailty Scale (CFS) and the 5 criterions frailty phenotype were used. In addition, the severity of the patients with the APACHE II, SAPS II and SOFA scales was assessed. For the analysis of the data, the SPSS 19 for windows statistical package was used and more specifically descriptive statistics and correlations with parametric methods were performed. RESULTS: Thirty-six severely ill patients aged 65 years and over (22 women, 14 men) were studied. 25% of the patients had a positive frailty phenotype, 44% were at an early stage, while 30.6% had a frailty negative phenotype. A significant correlation between CFS and APACHE (P=0.041), age (P=0.033), sex (P=0.049) and ADL mobility index (P=0.001) was found to be significant. Concerning mortality, 36.1% of patients died in ICU, 11.1% died within the next 6 months and 38.9% were alive. CONCLUSIONS: The findings of the study highlighted the onset of frailty syndrome in ICU patients. The objective assessment of the frailty syndrome of the seriously ill patient as well as the prognostic markers provides a clearer picture of its out-of-hospital condition and contributes to the collection of information on the outcomes of the in-hospital treatment.