Perioperative oral nutrition supplementation cuts sarcopaenia prevalence after radical cystectomy
Perioperative intake of an oral nutrition supplement may lead to a lower prevalence of sarcopaenia and fewer and less severe complications and readmissions among patients who undergo radical cystectomy, reports a study.
Sixty-one patients were randomly assigned to either an oral nutrition supplement or a multivitamin multimineral supplement twice daily during an 8-week perioperative period. Abdominal computerized tomography images at the L3 vertebra were analysed to determine body composition.
Sarcopaenia referred to a skeletal muscle index of <55 cm 2/m2 in males and <39 cm 2/m2 in females. The difference in 30-day hospital free days was the primary outcome, while secondary outcomes were hospital length of stay, complications, readmissions and mortality.
Patients in the oral nutrition supplement group lost less weight compared to those in the multivitamin multimineral supplement group (–5 vs –6.5 kg; p=0.04). The proportion of patients with sarcopaenia in the multivitamin multimineral supplement group increased by 20 percent, but that in the oral nutrition supplement group did not (p=0.01). Mean length of stay and 30-day hospital free days were similar in the two groups.
Rate of overall and major (Clavien grade ≥3) complications were lower in the oral nutrition supplement group (48 percent vs 67 percent and 19 percent vs 25 percent, respectively); readmission rate was also lower in this group (7 percent vs 17 percent), but these differences did not reach statistical significance.
“A larger blinded, randomized, controlled trial is necessary to determine whether oral nutrition supplement interventions can improve outcomes following radical cystectomy,” the authors said.