Poster Topical Area: Medical Nutrition

Location: Hall D

Poster Board Number: 652

P14-027 - Exploring the Differences Between Early and Traditional Diet Advancement in Postoperative Feeding Outcomes in Patients With an Ileostomy or Colostomy

Monday, Jun 11
8:00 AM – 3:00 PM

Objective: To assess the differences in postoperative feeding outcomes when comparing early and traditional diet advancement in patients who had an ileostomy or colostomy creation. We hypothesized that patients who receive early diet advancement would pass flatus and produce their first ostomy output earlier than patients who receive traditional diet advancement.


Methods:
At a U.S. tertiary care hospital, data from patients that underwent a new ileostomy or colostomy creation from June 1, 2013 to April 30, 2017 were extracted from a prospectively maintained institutional outcomes database. Patients who received early diet advancement (postoperative day 0 and 1) were compared to traditional diet advancement (postoperative day 2 and later) for demographics, preoperative risk factors (BMI, primary diagnosis) and operative features (surgical approach, type of ostomy). The postoperative feeding outcomes included time to first flatus and first ostomy output. Mann-Whitney U tests determined bivariate differences in postoperative feeding outcomes between the diet advancement groups. Poisson regression was used to adjust for unequal baseline characteristics.


Results:
Data from 255 patients were included; 204 (80.0%) received early diet advancement and 51 (20.0%) had traditional diet advancement. The mean age was 56.5 years (total sample), with slightly more males (52.5%) than females (47.5%). Cancer was the most frequently reported primary diagnosis (42.4%) with no difference between groups. Time to first flatus and time to first ostomy output were significantly shorter in the early compared to traditional diet advancement group (median difference 1 day for both flatus and ostomy output, p


Conclusions:
Early diet advancement is associated with earlier return of flatus and first ostomy output compared to traditional diet advancement after the creation of an ileostomy or colostomy.




Funding Source: N/A

CoAuthors: Joachim Sackey, PhD – School of Health Professions' Department of Nutritional Sciences at Rutgers University; Kate Willcutts, DCN, RDN, CNSC – University of Virginia Health System; James Parrott, PhD – School of Health Professions' Department of Nutritional Sciences at Rutgers University ; Jennifer Tomesko, DCN RD CNSC – School of Health Professions' Department of Nutritional Sciences at Rutgers University ; Ahmed Al-Mazrou, MBBS – NewYork-Presbyterian Hospital Columbia University Medical Center; Pokala Kiran, MD, FACS, FASCRS – NewYork-Presbyterian Hospital Columbia University Medical Center; Rebecca Brody, PhD, RD, LD, CNSC – School of Health Professions' Department of Nutritional Sciences at Rutgers University

Sabrina N. Toledano

Clinical Nutritionist: RD, CSO, CDN
NewYork-Presbyterian Columbia University Medical Center
Ny, New York