Complications after bariatric surgery: survey evaluating impact on the practice of specialized nutrition support.
BACKGROUND
The rapid growth of obesity rates has affected the practice of specialized nutrition support in various ways. One area that deserves special consideration is the impact that bariatric surgery, in particular complications resulting from bariatric surgery, has made on nutrition support practice. A descriptive survey was designed to evaluate this impact and to assess the various approaches to nutrition assessment and interventions in the postoperative bariatric surgery patient.


METHODS
A web-based survey consisting of 17 questions was administered in April 2006 to American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) members with available e-mail addresses. Participants were queried about professional background, primary practice setting, and various issues related to their involvement in the care of bariatric surgery patients.


RESULTS
There were 467 responses returned out of 3400 surveys delivered (14% response rate). Sixty percent of responders estimated they were consulted to see 1-10 patients requiring specialized nutrition support over the previous year as a result of complications of bariatric surgery. The most common indications for specialized nutrition support in these patients were anastomotic leak/fistula (49%) and chronic nausea/vomiting (27%). When estimating calorie goals, 62% used an adjusted body weight, 15% used ideal body weight, and 14% used actual weight. When estimating protein goals, 56% used an adjusted body weight, 29% used ideal body weight, and 8% used actual weight.


CONCLUSIONS
These observations provide impetus for guideline development and highlight the priority for further research regarding the best practices to ensure that postoperative bariatric surgery patients receive safe and appropriate nutrition support.
Vanderbilt University Medical Center, Center for Human Nutrition, 1121 21st Ave S, 514 Medical Arts Bldg, Nashville, TN 37232, USA. vanessa.kumpf@vanderbilt.edu
Vanessa J
VJ
Kumpf
Kelsey
K
Slocum
Jeff
J
Binkley
Gordon
G
Jensen
D050110:Bariatric Surgery / Q000009:adverse effects*; D005402:Fistula / Q000209:etiology / Q000628:therapy; D019538:Health Care Surveys; D006801:Humans; D008286:Malabsorption Syndromes / Q000209:etiology / Q000628:therapy; D018529:Nutritional Support; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000628:therapy*; D020250:Postoperative Nausea and Vomiting / Q000628:therapy; D011795:Surveys and Questionnaires