THE IMPACT OF THE NUTRICATT PROTOCOL ON BODY COMPOSITION OF SURGICAL PATIENTS OVER 75 YEARS OLD WITH COLORECTAL CANCER

Abstract

This study aimed to determine changes in nutritional status and their impact on clinical outcomes in elderly patients undergoing surgery for colorectal cancer (CRC), treated with the NutriCattä protocol. All patients undergoing surgery for CRC at the Fondazione Policlinico “A. Gemelli” – IRCCS were treated with the NutriCattä protocol, which consists of an implementation of the ERASä protocol with a nutritional prehabilitation. Bioimpedance analysis (BIA) was performed at prehospitalization (preH), hospital admission, and discharge. All data are expressed as mean±standard deviation and the Student's t-test for paired data was used to assess statistical differences. Between January 2016 and December 2019, 324 patients were enrolled, 100 of which over 75 years and 224 under 75 years (mean age ± SD respectively 67.8±11.9, 80.9±4.3, 61.9±9.2). In patients over 75 years the BIA-derived Phase Angle showed an improvement between preH and admission (4.65±0.79 vs 4.95±0.85, p<0.00001), a reduction during hospitalization (4.95±0.85 vs 4.75±0.9; p=0.0001) returning to the preH levels at discharge (4.75±0.9 vs 4.65±0.79; p=0.68). The mean postoperative hospital stay (POS) was not different between over 75 years and under 75 years patients (5.5±3.1 and 5.0±3.5 days, p=0.21, respectively). NutriCattä protocol was effective in improving nutritional status before surgery for CRC in patients over 75 years, obtaining the same POS as that of under 75 years patients, thus confirming the importance of a nutritional prehabilitation to prepare fragile subjects for major abdominal surgery.