Clinical effects of nutritional risk screening 2002-guided individualized nutritional intervention in postoperative colorectal cancer patients: A time-period comparison study

Table 1 Baseline characteristics comparison, n (%)/mean ± SD

Characteristic	Conventional group (n = 40)	ERAS group (n = 40)	Test statistic	P value
Age (years)	64.7 ± 11.8	63.2 ± 12.1	t = 0.586	0.561
Gender			χ2 = 0.050	0.823
Male	23 (57.5)	24 (60.0)
Female	17 (42.5)	16 (40.0)
BMI (kg/m2)	23.3 ± 3.1	23.5 ± 2.8	t = -0.329	0.743
Preoperative serum albumin (g/L)	38.7 ± 4.1	39.3 ± 3.6	t = -0.732	0.468
Tumor location			χ2 = 0.197	0.657
Colon	24 (60.0)	23 (57.5)
Rectum	16 (40.0)	17 (42.5)
TNM stage			χ2 = 0.461	0.794
Stage I	8 (20.0)	9 (22.5)
Stage II	18 (45.0)	17 (42.5)
Stage III	14 (35.0)	14 (35.0)
Tumor differentiation			χ2 = 0.324	0.851
Well differentiated	12 (30.0)	14 (35.0)
Moderately differentiated	22 (55.0)	21 (52.5)
Poorly differentiated	6 (15.0)	5 (12.5)
Surgical approach			χ2 = 0.145	0.703
Laparoscopic	28 (70.0)	29 (72.5)
Open surgery	12 (30.0)	11 (27.5)
Anesthesia time (minutes)	147.2 ± 29.3	143.8 ± 30.7	t = 0.543	0.589
ASA score			χ2 = 0.074	0.786
I-II	32 (80.0)	33 (82.5)
III	8 (20.0)	7 (17.5)

P values for continuous variables calculated using independent t-test, categorical variables using χ² test or Fisher’s exact test. BMI: Body mass index; TNM: Tumor-node-metastasis; ASA: American Society of Anesthesiologists; ERAS: Enhanced recovery after surgery.

Table 2 Enhanced recovery after surgery group nutritional risk assessment results, n (%)/mean ± SD

Clinical parameter	No risk (n = 13)	Moderate risk (n = 16)	High risk (n = 11)	P value
Age (years)	58.4 ± 10.2	64.8 ± 11.5	68.3 ± 12.7	0.037
BMI (kg/m2)	24.8 ± 2.3	23.2 ± 2.8	21.9 ± 3.4	0.021
Preoperative weight loss				< 0.001
None	13 (100.0)	7 (43.8)	0 (0.0)
5%-10%	0 (0.0)	8 (50.0)	2 (18.2)
> 10%	0 (0.0)	1 (6.2)	9 (81.8)
Appetite status				< 0.001
Normal	13 (100.0)	4 (25.0)	1 (9.1)
Decreased	0 (0.0)	12 (75.0)	10 (90.9)
Serum albumin (g/L)	41.2 ± 2.8	38.9 ± 3.1	33.8 ± 4.2	< 0.001
Hypoalbuminemia (< 35 g/L)	0 (0.0)	2 (12.5)	7 (63.6)	< 0.001
Prealbumin (mg/L)	278.6 ± 35.4	215.3 ± 42.1	165.8 ± 38.7	< 0.001
Hypoprealbuminemia (< 200 mg/L)	0 (0.0)	5 (31.3)	9 (81.8)	< 0.001
Hemoglobin (g/L)	128.4 ± 11.2	118.7 ± 13.5	106.9 ± 15.8	< 0.001

BMI: Body mass index.

Table 3 Changes in serum nutritional indicators, mean ± SD

Indicator	Time Point	Conventional group (n = 40)	ERAS group (n = 40)	Test statistic	P value
Serum albumin (g/L)
	Preoperative	38.7 ± 4.1	39.3 ± 3.6	t = -0.732	0.468
	7 days postop	33.2 ± 4.2	36.8 ± 3.1	t = -4.326	< 0.01
	14 days postop	35.1 ± 3.9	39.5 ± 2.8	t = -5.612	< 0.01
Prealbumin (mg/L)
	Preoperative	235.4 ± 48.3	241.7 ± 44.2	t = -0.612	0.543
	7 days postop	198.7 ± 52.1	265.3 ± 45.2	t = -6.041	< 0.001
	14 days postop	235.6 ± 47.3	321.8 ± 38.4	t = -8.754	< 0.001
Hemoglobin (g/L)
	Preoperative	122.8 ± 14.6	125.3 ± 12.9	t = -0.812	0.419
	7 days postop	106.4 ± 16.2	112.7 ± 13.8	t = -1.878	0.064
	14 days postop	108.2 ± 15.7	118.5 ± 12.3	t = -3.247	< 0.01
Total protein (g/L)
	Preoperative	68.5 ± 6.2	69.8 ± 5.7	t = -0.987	0.327
	7 days postop	62.3 ± 7.1	66.9 ± 5.9	t = -3.154	< 0.01
	14 days postop	64.7 ± 6.8	70.2 ± 5.4	t = -4.038	< 0.001
Transferrin (mg/L)
	Preoperative	2.48 ± 0.42	2.52 ± 0.38	t = -0.452	0.653
	7 days postop	2.12 ± 0.48	2.67 ± 0.41	t = -5.462	< 0.001
	14 days postop	2.28 ± 0.45	2.89 ± 0.37	t = -6.523	< 0.001

ERAS: Enhanced recovery after surgery.

Table 4 Inflammatory response indicator comparison, mean ± SD

Indicator	Time point	Conventional group (n = 40)	ERAS group (n = 40)	Test statistic	P value
C-reactive protein (mg/L)
	Preoperative	4.2 ± 2.1	3.8 ± 1.9	t = 0.894	0.374
	Postop day 3	23.7 ± 9.1	15.2 ± 6.8	t = 4.652	< 0.001
	Postop day 7	14.8 ± 6.5	8.6 ± 4.2	t = 4.891	< 0.001
Interleukin-6 (pg/mL)
	Preoperative	3.2 ± 1.8	2.9 ± 1.6	t = 0.796	0.428
	Postop day 3	28.9 ± 11.2	18.4 ± 7.3	t = 4.721	< 0.001
	Postop day 7	19.7 ± 8.4	12.1 ± 5.8	t = 4.587	< 0.001
White blood cell count (× 109/L)
	Preoperative	6.8 ± 2.3	6.5 ± 2.1	t = 0.618	0.538
	Postop day 3	12.4 ± 3.7	9.8 ± 2.9	t = 3.423	< 0.01
	Postop day 7	9.6 ± 3.2	7.4 ± 2.5	t = 3.341	< 0.01
Neutrophil percentage (%)
	Preoperative	62.8 ± 8.4	61.5 ± 7.9	t = 0.721	0.473
	Postop day 3	78.9 ± 9.6	72.3 ± 8.2	t = 3.267	< 0.01
	Postop day 7	71.4 ± 8.8	66.2 ± 7.6	t = 2.816	< 0.01
Erythrocyte sedimentation rate (mm/hour)
	Preoperative	18.4 ± 12.6	16.8 ± 11.3	t = 0.594	0.554
	Postop day 7	42.8 ± 18.2	31.5 ± 14.7	t = 2.978	< 0.01
	Postop day 14	35.6 ± 15.9	24.8 ± 12.4	t = 3.321	< 0.01

ERAS: Enhanced recovery after surgery.

Table 5 Gastrointestinal function recovery, mean ± SD

Recovery parameter	Conventional group (n = 40)	ERAS group (n = 40)	Test statistic	P value
First flatus time (days)	3.2 ± 1.1	2.1 ± 0.8	t = 4.987	< 0.001
First defecation time (days)	4.6 ± 1.5	3.2 ± 1.2	t = 4.564	< 0.001
Bowel sound recovery time (days)	4.1 ± 1.3	2.8 ± 1.0	t = 4.873	< 0.001
Time to tolerate clear liquids (days)	1.8 ± 0.9	0.9 ± 0.5	t = 5.287	< 0.001
Time to tolerate semi-solid diet (days)	3.4 ± 1.2	2.3 ± 0.8	t = 4.721	< 0.001
Time to resume normal diet (days)	6.2 ± 1.8	4.1 ± 1.3	t = 5.826	< 0.001

ERAS: Enhanced recovery after surgery.