title: Postoperative nutrition practices in abdominal surgery patients in a tertiary referral hospital Intensive Care Unit: A prospective analysis.
abstract: BACKGROUND
  Benefit of early enteral feeds in surgical patients admitted to Intensive Care Units (ICUs) has been emphasized by several studies. Apprehensions about anastomotic leaks in gastrointestinal surgical patients prevent initiation of early enteral nutrition (EN). The impact of these practices on outcome in Indian scenario is less studied.
  
  
  OBJECTIVE
  This study compares the impact of early EN (within 48 h after surgery) with late EN (48 h postsurgery) on outcomes in abdominal surgical ICU patients.
  
  
  METHODS
  Postabdominal surgery patients admitted to a tertiary referral hospital ICU over a 2-year period were analyzed.
  
  
  METHODS
  Only patients directly admitted to ICU after abdominal surgery were included in this study. ICU stay>3 days was considered as prolonged; with average ICU length of stay (LOS) for this ICU being 3 days. The primary outcome was in-patient mortality. ICU LOS, hospital LOS, infection rates, and ventilator days were secondary outcome measures. Acute Physiology and Chronic Health Evaluation II scores were calculated. SPSS and Microsoft Excel were used for analysis.
  
  
  RESULTS
  Of 91 ICU patients included, 58 received early EN and 33 late EN. Hospital LOS and infection rates were less in early EN group. Use of parenteral nutrition (odds ratio [OR] 5.25, 95% confidence interval (CI); P = 0.003) and number of nil-per-oral days (OR 8.25, 95% CI; P ≤ 0.001) were other predictors of prolonged LOS.
  
  
  CONCLUSIONS
  Early EN in postabdominal surgery ICU patients was associated with reduced hospital LOS and infection rates. ICU LOS, duration of mechanical ventilation and mortality rates did not vary.
authors.affiliation: Intensive Care Unit, Columbiaasia Referral Hospital, Yeshwantpur, Bengaluru, Karnataka, India.
authors.forename: Tejaswini Arunachala
authors.initials: TA
authors.lastname: Murthy
authors.affiliation: Intensive Care Unit, Columbiaasia Referral Hospital, Yeshwantpur, Bengaluru, Karnataka, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Rangappa
authors.affiliation: General Manager, Pharmacy, IMO, Columbiaasia Hospitals, Bengaluru, Karnataka, India.
authors.forename: B J
authors.initials: BJ
authors.lastname: Anil
authors.affiliation: Intensive Care Unit, Columbiaasia Referral Hospital, Yeshwantpur, Bengaluru, Karnataka, India.
authors.forename: Ipe
authors.initials: I
authors.lastname: Jacob
authors.affiliation: Intensive Care Unit, Columbiaasia Referral Hospital, Yeshwantpur, Bengaluru, Karnataka, India.
authors.forename: Karthik
authors.initials: K
authors.lastname: Rao
keywords: Hospital mortality; infection rates; nutrition; outcomes