Personalized nutritional care for immune function recovery in postoperative gastrointestinal surgery patients: An observational study

Table 1 Baseline characteristics of study participants, mean ± SD or n (%)

Characteristic	Value
Age (years)	62.5 ± 11.3
Gender (M/F)	45/35
BMI (kg/m²)	24.3 ± 3.8
Type of surgery (%)
Colectomy	30 (37.5)
Gastrectomy	25 (31.25)
Pancreaticoduodenectomy	15 (18.75)
Other	10 (12.5)
Preoperative SGA score (%)
A (well-nourished)	50 (62.5)
B (mild-moderate malnutrition)	25 (31.25)
C (severe malnutrition)	5 (6.25)
Comorbidities (%)
Hypertension	35 (43.75)
Diabetes mellitus	20 (25)
Chronic obstructive pulmonary disease	10 (12.5)
ASA score (%)
I	10 (12.5)
II	45 (56.25)
III	25 (31.25)

BMI: Body mass index; SGA: Subjective global assessment; ASA: American Society of Anesthesiologists.

Table 2 Changes in immune function markers over time, mean ± SD

Marker	Baseline	Week 1	Week 2	Week 4	P value
CD4+ T cells (cells/μL)	820 ± 210	650 ± 180	750 ± 200	1025 ± 250	< 0.001
CD8+ T cells (cells/μL)	510 ± 150	420 ± 130	480 ± 140	590 ± 160	< 0.001
NK cells (cells/μL)	220 ± 80	180 ± 70	210 ± 75	250 ± 85	< 0.001
IL-6 (pg/mL)	5.2 ± 2.1	45.6 ± 15.3	22.3 ± 8.7	3.1 ± 1.8	< 0.001
TNF-α (pg/mL)	12.5 ± 4.3	28.7 ± 9.5	18.9 ± 6.2	10.8 ± 3.9	< 0.001
IL-10 (pg/mL)	3.8 ± 1.5	8.9 ± 3.2	6.5 ± 2.4	5.2 ± 1.9	< 0.001
IgG (g/L)	10.5 ± 2.3	8.7 ± 2.0	9.6 ± 2.1	10.8 ± 2.4	< 0.001

P values represent the overall change over time (repeated-measures measures ANOVA). TNF-α: Tumor necrosis factor-α; IL: Interleukin.

Table 3 Changes in nutritional parameters over time, mean ± SD

Parameter	Baseline	Week 1	Week 2	Week 4	P value
Body weight (kg)	68.5 ± 12.3	66.2 ± 11.8	67.1 ± 12.0	68.9 ± 12.5	< 0.001
BMI (kg/m²)	24.3 ± 3.8	23.5 ± 3.6	23.8 ± 3.7	24.5 ± 3.9	< 0.001
MAMC (cm)	25.8 ± 3.2	24.9 ± 3.0	25.5 ± 3.1	26.3 ± 3.3	< 0.001
Prealbumin (mg/dL)	25.3 ± 5.7	18.6 ± 4.2	22.9 ± 5.1	28.4 ± 6.3	< 0.001
Transferrin (mg/dL)	220 ± 45	185 ± 38	205 ± 42	235 ± 48	< 0.001
Handgrip strength (kg)	28.5 ± 8.2	24.7 ± 7.1	26.9 ± 7.7	30.2 ± 8.6	< 0.001

P values represent overall change over time (repeated-measures ANOVA). BMI: Body mass index; MAMC: Mid-arm muscle circumference.

Table 4 Changes in European Organization for Research and Treatment of Cancer Quality of Life Questionnaire scores over time, mean ± SD

Scale	Baseline	Week 4	Week 12	P value
Global health status/QoL	62.3 ± 18.5	70.1 ± 16.9	78.6 ± 15.7	< 0.001
Physical functioning	75.2 ± 20.3	82.7 ± 18.5	89.5 ± 16.8	< 0.001
Role functioning	68.7 ± 25.6	77.3 ± 22.9	85.9 ± 20.1	< 0.001
Emotional functioning	71.5 ± 22.8	79.4 ± 20.3	86.2 ± 18.7	< 0.001
Cognitive functioning	83.9 ± 17.2	87.5 ± 15.8	90.8 ± 14.3	< 0.001
Social functioning	70.6 ± 24.1	79.2 ± 21.5	86.7 ± 19.2	< 0.001
Fatigue	42.8 ± 26.3	32.5 ± 23.7	24.1 ± 20.9	< 0.001
Pain	28.7 ± 25.9	18.3 ± 20.6	11.5 ± 16.8	< 0.001
Appetite loss	31.2 ± 30.5	20.8 ± 25.3	12.4 ± 19.7	< 0.001

P values represent the overall change over time (repeated-measures ANOVA). Higher scores represent better functioning for functional scales and global quality of life and worse symptoms for symptom scales. QoL: Quality of life.