Impact of Caloric and Protein Adequacy on Postoperative Clinical Outcomes of Patients Undergoing Major Abdominal Surgery

Study Overview
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Brief Summary
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The role of nutritional therapy (TN) in the surgical patient is well described in the literature and is associated with reductions in postoperative complications, length of hospital stay, and mortality. Adequate determination of caloric and protein requirements is an essential step in the TN institution, avoiding hypoalimentation and hyperalimentation. Thus, it is essential to understand the changes in energy expenditure after surgery and its relation with nutritional status. In addition, little is known about the effect of nutritional therapy and caloric adequacy on parameters such as phase angle and dynamometry. Thus, the objective of this study is to evaluate the changes in energy expenditure after major abdominal surgeries and to evaluate the phase angle and dynamometry as possible markers of nutritional therapy. Energy expenditure will be assessed by indirect calorimetry. Functionality will be assessed by means of dynamometry and 6-minute walk test. Nutritional diagnosis will be given through subjective global assessment. Energy and protein intake will be monitored and registered daily. Phase angle will be obtained by performing bioelectrical impedance.

Official Title
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Impact of Caloric and Protein Adequacy on Postoperative Clinical Outcomes of Patients Undergoing Major Abdominal Surgery

Conditions
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Surgery, Postoperative Complications, Cancer, Energy Supply; Deficiency

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Over 18 years old Patients admitted for major abdominal surgery Sign the consent form Exclusion Criteria: Length of hospital stay less than 3 days Pregnancy Patients who, for any reason, can not perform indirect calorimetry

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Study group<br>Surgical patients receiving nutritional support (enteral and/or parenteral nutrition) pre and/or after surgery | |
| Control group<br>Surgical patients without nutritional support during the perioperative period | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative complications | According to the Dindo-Clavien protocol | 30 days after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Phase angle | Changes in phase angle after surgery as measured by bioelectrical impedance | 24 hours pre-surgery, 3 and 7 days after surgery | 
| Body composition | Changes in body composition after surgery as measured by bioelectrical impedance | 24 hours pre-surgery, 3 and 7 days after surgery | 
| Nutritional status | Changes in nutritional status after surgery as assessed by subjective global assessment (SGA) | 24 hours pre-surgery and 7 days after surgery | 
| Functional status | Changes in functional status after surgery as assessed by hand grip strength | 24 hours pre-surgery, 3 and 7 days after surgery | 
| Energy expenditure | Changes in energy expenditure after surgery measured by indirect calorimetry | 3, 5 and 7 days after surgery |