NutriCatt Protocol Improves Body Composition and Clinical Outcomes in Elderly Patients Undergoing Colorectal Surgery in ERAS Program: A Retrospective Cohort Study

• Main Authors: Emanuele Rinninella, Alberto Biondi, Marco Cintoni, Pauline Raoul, Francesca Scialanga, Eleonora Persichetti, Gabriele Pulcini, Roberto Pezzuto, Roberto Persiani, Domenico D’Ugo, Antonio Gasbarrini, Maria Cristina Mele
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: Nutrients
• Subjects: nutritional support; colorectal surgery; elderly; body composition; BIA; phase angle
• Online Access: https://www.mdpi.com/2072-6643/13/6/1781

Background: A poor body composition, often found in elderly patients, negatively impacts perioperative outcomes. We evaluated the effect of a perioperative nutritional protocol (NutriCatt) on body composition and clinical outcomes in a cohort of elderly patients undergoing colorectal surgery in a high-volume center adopting the ERAS program. Methods: 302 out of 332 elderly (>75 years) patients from 2015 to 2020 were identified. Patients were divided according to their adherence, into “NutriCatt + ERAS” (<i>n</i> = 166) or “standard ERAS” patients (<i>n</i> = 136). Anthropometric and bioelectrical impedance analysis data were evaluated for NutriCatt + ERAS patients. Complications, length of hospital stay (LOS), and other postoperative outcomes were compared between both groups. <i>Results:</i> In NutriCatt + ERAS patients, significant improvements of phase angle (pre-admission vs. admission 4.61 ± 0.79 vs. 4.84 ± 0.85; <i>p</i> = 0.001; pre-admission vs. discharge 4.61 ± 0.79 vs. 5.85 ± 0.73; <i>p</i> = 0.0002) and body cell mass (pre-admission vs. admission 22.4 ± 5.6 vs. 23.2 ± 5.7; <i>p</i> = 0.03; pre-admission vs. discharge 22.4 ± 5.6 vs. 23.1 ± 5.8; <i>p</i> = 0.02) were shown. NutriCatt + ERAS patients reported reduced LOS (<i>p</i> = 0.03) and severe complications (<i>p</i> = 0.03) compared to standard ERAS patients. A regression analysis confirmed the protective effect of the NutriCatt protocol on severe complications (OR 0.10, 95% CI 0.01–0.56; <i>p</i> = 0.009). Conclusions: The NutriCatt protocol improves clinical outcomes in elderly patients and should be recommended in ERAS colorectal surgery.