Malnourished, gastrointestinal cancer patients undergoing surgery: burden of nutritional risk, use of oral nutritional supplements, and impact on health outcomes.

Patients with gastrointestinal (GI) malignancies are at high risk for malnutrition because of reduced food intake, poor digestion, and altered absorption. In a ret-rospective review of medical records for patients admitted to urban hospitals in an Asian nation for GI tumor surgery (gastric, colon, or anorectal cancers), we found that malnutrition was common yet often overlooked. Our review identified records for 349 adult GI-tumor surgery patients. The Nutrition Risk Screening-2002 (NRS-2002) was the most frequently used screening instrument. In further review, we compared outcomes for malnourished GI tumor surgery patients given daily oral nutritional supplements (ONS) to outcomes for patients who were not given ONS. Review of results revealed that only 20% of patients in our sample underwent nutritional screening or assessment on admission. Of those who did, nearly 60% were malnourished. Although due to small sample sizes, no statistically significant differences were observed, mal-nourished patients who received ONS had fewer complications and shorter lengths of stay by 1-day. Such findings reveal many missed opportunities to improve patient outcomes and to avert excess healthcare costs for treatment of complications, slowed recovery, longer hospital stays, and readmissions. Based on our findings, nutritional training for professionals is necessary to address the serious problems of under-recognition and inadequate treatment of malnutrition in hospitalized patients.