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Malnutrition priori a major abdominal surgery is frequent and increases morbidity and mortality. The management of malnutrition has an impact in reducing postoperative complications. However malnutrition is rarely detected and Guidelines infrequently followed.
Recovery time and nutritional evaluation in elderly patients are major criteria in their postoperative management. Identifying malnutrition or malnutrition risk is fundamental to its treatment. It is therefore unsurprising that many validated tools for nutrition risk screening and nutrition assessment exist for the clinician to use in assisting with the accurate identification, referral and treatment of patients who are malnourished or at risk of malnutrition.
And nutritional management must be adapted and based on this evaluation and evolution of the general status (Guidelines Grade A).
A geriatric evaluation based on a screening of preoperative malnutrition should allow a better implementation of the European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines.
Assessing the impact of a geriatric action (Team Mobile Geriatrics, EMG, or if the geriatric facility team when it does not have EMG) on the rate of nutritional support perioperative elderly subjects (≥ 70 years) who underwent a colorectal cancer according to ESPEN recommendations and SFNEP.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Nutritional evaluation | No Intervention |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Malnutrition screening and perioperative nutritional support | Procedure |
|
| Measure | Description | Time Frame |
|---|---|---|
| Perioperative nutritional management | Rate of nutritional support implemented in accordance with current European guidelines (ESPEN) | During perioperative period From D-7 before date of hospitalization until discharge from the hospital, up to 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Malnutrition screening | Rate of malnutrition screening procedure | During preoperative seven days |
| Rate of preoperative nutritional management by immunonutrition implemented | Nutritional management by immunonutrition implemented is based on a complete nutritional evaluation |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marc BONNEFOY, PHD | Contact | +33 4 788 615 81 | marc.bonnefoy@chu-lyon.fr | |
| Laurent VILLENEUVE | Contact | +33 4 788 645 36 | laurent.villeneuve@chu-lyon.fr |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Professeur Marc BONNEFOY | Recruiting | Pierre-Bénite | 69495 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28061830 | Derived | Dupuis M, Kuczewski E, Villeneuve L, Bin-Dorel S, Haine M, Falandry C, Gilbert T, Passot G, Glehen O, Bonnefoy M. Age Nutrition Chirugie (ANC) study: impact of a geriatric intervention on the screening and management of undernutrition in elderly patients operated on for colon cancer, a stepped wedge controlled trial. BMC Geriatr. 2017 Jan 7;17(1):10. doi: 10.1186/s12877-016-0402-3. |
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|
| During preoperative seven days |
| Rate of malnourished patients | Rate of malnourished patients is defined by the ESPEN criteria | During preoperative seven days |
| Rate of patients with cachexia | Rate of patients with cachexia is defined by the French National Authority for Health (HAS) criteria | Seventh day preoperative |
| Postoperative complications | Rate and type of postoperative complications (Grade I, II et IIIa of Dindo classification) | Postoperative follow-up until discharge from hospital, up to 30 days |
| Rate of postoperative nutritional management implemented | Nutritional management implemented is based on the ESPEN guidelines | Postoperative follow-up until discharge from hospital, up to 30 days |
| Evolution of the activities of daily living | Variations of Activities of daily living (ADL) and Instrumental activities of daily living (IADL) scores | During preoperative seven days and postoperative follow-up until discharge from hospital, up to 30 days |
| ID | Term |
|---|---|
| D015179 | Colorectal Neoplasms |
| D009369 | Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
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