Is enhanced recovery after surgery safe and beneficial for the elderly?
- Author:
Ho Chiou YI
1
Author Information
1. Dietetics and Food Service Department, National Cancer Institute, Putrajaya, Malaysia
- Publication Type:Case Report
- Keywords:
Enhanced recovery after surgery;
clear fluid;
elderly;
length of hospital stay
- From:
Malaysian Journal of Nutrition
2018;24(1):149-152
- CountryMalaysia
- Language:English
-
Abstract:
ntroduction: Enhanced recovery after surgery (ERAS) protocols are multidisciplinary perioperative care aimed to achieve early recovery after surgery by maintaining preoperative organ function and reducing the surgical induced stress response. Case presentation: A 79-year-old female patient with Transverse Colon Adenocarcinoma, elective admitted for colon resection. Patient was cachexia with weight 33 kg; loss of 7 kg within 1 month; PGSGA score 14 (severe malnourished); Albumin 30 g/L. She experienced very poor oral intake for past 1 month with intake of 450 kcal/day and 15 g/day protein. Carbohydrate loading with 100 g carbohydrate as evening drink and 50 g carbohydrate 3 hours pre-operation. Clear fluid (carbohydrate plus whey protein drink) was allowed on the first day of operation (POD). Regular diet was started on the POD3 since patient tolerated 500 ml of clear fluid. Patient tolerated well with solid food on POD4 and allowed discharged on POD5. As summary, length of hospital stay 5 days 2 hours, ambulation length 20 hours, length of clear fluid toleration 18 hours, length of solid food toleration 4 days and length of gastrointestinal function (flatus & bowel open) 4.5 days. Discussion: Advanced age is a proven risk factor of post-operative complications. Shorter hospital stay was found associated with a lower risk of post-operative complications. Length of hospitalization after colorectal surgery does not significantly differ between younger and older age groups of the patients. Conclusion: ERAS showed good overall outcome even elderly. Good quality of care at home is required and crucial as well after quicker discharged.
