OGC P17 Reporting nutritional outcomes following gastrectomy: A systematic mapping review

Abstract

Abstract Background Following an international consensus agreement of patients and healthcare professionals (GASTROS Study), ‘nutritional outcomes’ have been identified as critically important to report in surgical trials for gastric cancer. A previous review has demonstrated that nutritional outcomes are rarely reported by trials, and little is known about how best to measure them. In preparation for future work on establishing an optimum approach to report and measure nutritional outcomes, a mapping review was undertaken to examine current approaches used by researchers in this field. Methods We conducted a systematic literature search (using MEDLINE, Embase, CINAHL, Cochrane and PsychInfo) and included randomised control trials and prospective studies reporting any form of nutritional outcome in patients following gastrectomy, between 2012 and 2022. The review was conducted using PRISMA guidelines and registered on the PROSPERO database (CRD42022365652). Full text reviews and data extraction were completed independently by three reviewers. Datapoints of interest included general trial and surgery characteristics, study types, duration and frequency of nutritional outcomes and the utility of nutritional screening measurement tools. Data collection and analysis was conducted on Microsoft Excel. Results 3288 abstracts were screened, yielding 87 studies (17220 patients) eligible for inclusion. 90% of trials were based in East Asia. 24% of trials reported biochemical, anthropometric, and weight-based outcomes. 21 different biochemical tests were reported by 74% trials, the most common marker being ‘albumin’. Anthropometric measurements were heterogenous with BMI and skeletal muscle index being the most frequently reported. 66% of studies reported patient weight as an outcome. 28% studies reported both nutritional screening and assessment. 48% of trials utilised screening tools. The frequency and time points at which nutritional outcomes were measured varied greatly. Conclusions This mapping review highlights significant variation in the reporting of nutritional outcomes. Consensus agreement is required to establish the optimum approach to use in trials and clinical practice.