ANC1 Study Impact of a Geriatric and Nutritional Evaluation for the Malnutrition and Malnutrition Risk Screening in Patients Over 70 Years With Colorectal Surgery.

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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ANC1 Study Impact of a Geriatric and Nutritional Evaluation for the Malnutrition and Malnutrition Risk Screening in Patients Over 70 Years With Colorectal Surgery.

Conditions
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Colorectal Tumor

Intervention / Treatment
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* Procedure: Malnutrition screening and perioperative nutritional support


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged ≥ 70 years Colorectal or tumor resection with/without synchronous metastases Exclusion Criteria: Emergency resection of colorectal tumor Unresectable colorectal tumor with/without synchronous metastases

Ages Eligible for Study
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Minimum Age: 70 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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Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Nutritional evaluation<br> | Procedure: Malnutrition screening and perioperative nutritional support<br>* 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<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perioperative nutritional management | Rate of nutritional support implemented in accordance with current European guidelines (ESPEN) | During perioperative period From D-7 before date of hospitalization until discharge from the hospital, up to 30 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Malnutrition screening | Rate of malnutrition screening procedure | During preoperative seven days | 
| Rate of preoperative nutritional management by immunonutrition implemented | Nutritional management by immunonutrition implemented is based on a complete nutritional evaluation | During preoperative seven days | 
| Rate of malnourished patients | Rate of malnourished patients is defined by the ESPEN criteria | 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 | Seventh day preoperative | 
| Postoperative complications | Rate and type of postoperative complications (Grade I, II et IIIa of Dindo classification) | 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 | 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 | During preoperative seven days and postoperative follow-up until discharge from hospital, up to 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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vulnerable, nutrition, cancer, colorectal, tumor