Preoperative nutrition programme reduces surgical complications and costs
A new study projects significant reductions in postoperative complications and substantial cost savings through the implementation of a system-wide preoperative nutrition programme.
Researchers from the Allegheny Health Network have found that a preoperative nutrition programme could lead to an 18% decrease in hospitalisation days and a 33% reduction in postoperative complications across multiple surgical specialties. The study, set to be presented at the American College of Surgeons (ACS) Clinical Congress 2024 in San Francisco, California (19-22 Oct 2024), demonstrates the potential for improved patient outcomes and considerable cost savings for healthcare systems.
Methodology and findings
The research team analysed administrative claims data from 4,078 surgical cases within the Allegheny Health Network healthcare system, encompassing eight surgical specialties. Through a systematic review, they projected the impact of preoperative nutrition on hospitalisation and long-term complication rates.
The study’s findings indicate a cumulative reduction of 2,699 hospital days and 865 outlier days (hospital days exceeding 30) over the study period. This reduction in healthcare utilisation translated to a projected annual savings of US$7.8 million (about £6.2 million).
Dr Edward A. Joseph, lead author and cancer clinical outcomes research fellow at the Allegheny Health Network, emphasised the significance of these results: “Our findings show that incorporating preoperative nutrition as a standard part of surgical care can lead to significant reductions in health care utilisation and costs. These results emphasise the importance of routine nutritional support in the preoperative period to enhance patient recovery and reduce financial burdens on health care systems.”
Cost-effectiveness of the programme
The researchers estimated the total healthcare utilisation cost for the analysed procedures to be approximately $130.9 million. The preoperative nutrition programme, costing about $244,680 annually for 4,078 patients at $60 per nutrition bundle, resulted in the projected $7.8 million annual savings for the payer/insurance sector.
Notably, the reduction in “outlier days” – hospital days exceeding the expected duration – accounted for $6.1 million of the projected savings. An additional $1.9 million in savings was attributed to the decrease in long-term complications.
Composition of the nutrition programme
The nutrition packages used in the study consist of immunonutrition shakes containing omega-3 fatty acids and arginine, designed to support immune health and surgical recovery. These over-the-counter supplements are administered before surgery to help patients “carbo-load”, potentially improving general well-being both pre- and post-surgery.
Historically, such nutrition programmes were primarily used for cancer patients. However, the study suggests potential benefits in expanding their use to a broader range of surgical patients.
Implications for healthcare providers
While the study focused on cost savings for the payer/insurance sector, healthcare providers stand to benefit from the overall reduction in hospital days and decreased complications. These improvements can lead to better resource utilisation and potential cost savings in terms of staffing, bed availability, and other operational costs.
The study authors advocate for more widespread implementation of preoperative nutritional support, citing clear pathways to improving care and reducing costs. Dr Joseph concluded: “These findings underscore the need for more widespread implementation of preoperative nutritional support, as it offers a clear path to improving care and reducing costs.”
Reference:
Joseph, E. A., Bloom, N., Hamlet, C., Bartlett, D. L., Chalikonda, S., & Allen, C. J. (2024). Projected Financial Implications of a System-Wide Preoperative Nutrition Program. Scientific Forum, American College of Surgeons (ACS) Clinical Congress 2024.
