The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .
In 1995 a correlation between malnutrition and poor outcome in critically ill patients still exists.
After more than two decades of nutritional awareness , we design ed a prospect i ve study to determine whether malnutrition is still a significant issue in hospitalized patients . Patients admitted to an intensive care unit ( ICU ) were divided into well-nourished and malnourished groups , according to their nutritional status as assessed by serum albumin level and weight/height ratio . Severity of illness , as assessed by the Therapeutic Intervention Scoring System ( TISS ) , was used to further stratify the study population . All patients were followed clinical ly until discharge or death and their outcome recorded . Of 129 patients studied , 43 % were malnourished .  Length of hospital stay ( p = n.s . ) , incidence of complications ( p < 0.01 ) , and number of patients not discharged from hospital ( p < 0.05 ) were greater in the malnourished patients than in the well-nourished . In patients with less severe degrees of illness , the existence of malnutrition led to a worse outcome than in sicker patients . To further assess the clinical setting in which hospital-related malnutrition develops or is exacerbated , postoperative patients admitted to the ICU ( n = 66 ) were also studied in a nutritional survey ; the results of this survey indicate that : ( a ) the incidence of malnutrition in the surgical population is similar to that in the whole study population , and ( b ) hospital-related malnutrition in surgical patients mainly develops during their preoperative stay in general wards . Whereas our conclusion that patients ' outcome is adversely affected by a poor nutritional status is not new or startling , malnutrition continues to be a persistent problem in hospitalized patients , which can be readily identified using simple and easily available indices and , furthermore , readily treated
The present systematic review shows that , with the exception of laparoscopic surgery , objective evidence of the effect of individual components of ERAS protocol s in reducing the stress response following colorectal surgery is limited
Abstract Enhanced Recovery or Fast Track Recovery after Surgery protocol s ( ERAS ) have significantly changed perioperative care following colorectal surgery and are promoted as reducing the stress response to surgery .