title: The economic impact of early enteral feeding in gastrointestinal surgery: a prospective survey of 51 consecutive patients.
abstract: Early postoperative oral feeding has been demonstrated to be safe and not increase postoperative morbidity. There are conflicting reports about its effect on postoperative length of stay. Some patients will fail attempts at early postoperative feeding and may be relegated to a longer postoperative course. Few studies to date have attempted to identify cost savings associated with early oral support, and those identified address nasoenteric support only. Fifty-one consecutive patients were randomized into either a traditional postoperative feeding group or an early postoperative feeding group after their gastrointestinal surgery. Length of hospital stay, hospital costs (excluding operating room costs), morbidity, and time to tolerance of a diet were compared. There was a tendency toward increased nasogastric tube use in the early feeding arm, but the morbidity rates were similar. Length of hospital stay and costs were similar in both arms. Early postoperative enteral support does not reduce hospital stay, nursing workload, or costs. It may come at a cost of higher nasogastric tube use, however, without an increase in postoperative morbidity.
authors.affiliation: Department of General Surgery, Division of Colon and Rectal Surgery, Naval Medical Center, Portsmouth, Virginia 23708-2197, USA.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Lucha
authors.forename: Ralph
authors.initials: R
authors.lastname: Butler
authors.forename: Jessica
authors.initials: J
authors.lastname: Plichta
authors.forename: Michael
authors.initials: M
authors.lastname: Francis
mesh_terms: D000328:Adult; D000368:Aged; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D013505:Digestive System Surgical Procedures / Q000191:economics / Q000379:methods; D004750:Enteral Nutrition / Q000191:economics* / Q000379:methods; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000191:economics* / Q000379:methods; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D014481:United States