CN11 - Impact of a surgical ward breakfast buffet on nutritional intake in postoperative (oncological) patients

Background

Early return to normal intake and early mobilization enhances postoperative recovery. However, one out of six surgical patients is undernourished during hospitalization and approximately half of the patients eat 50% or less of the food provided to them. We assessed the use of newly introduced breakfast buffets in two wards for gastrointestinal and oncological surgery, and determined the impact on postoperative protein and energy intake.

Methods

A prospective pilot cohort study was conducted to assess the impact of the introduction of breakfast buffets in two surgical wards. Adult patients were actively invited to make use of the buffet each day, but could also make use of the regular service. Therefore, the study consisted out of one group of patients who used the buffet in greater or lesser extent. Additional food products (e.g., warm crepes, boiled eggs and a yoghurt bar with toppings) were offered to support use of the buffet. Furthermore, to make the buffet attractive the lounge was decorated with new chairs, tables for two, and some decoration items. Primary outcomes were protein and energy intake during breakfast. We asked patients to report the type of breakfast service and breakfast intake in a diary up to a seven day follow-up period. Prognostic factors were used during multivariable regression analysis.

Results

A total of 77 patients were included in the study from which 57% were oncological patients. Per patient the median use of the breakfast buffet over the follow-up period was 50% (IQR 0 – 83). Mean protein intake was 14.7 grams (SD 8.4) and mean energy intake 332.3 kilocalories (SD 156.9). Predictors for higher protein intake included use of the breakfast buffet (β=0.06, p=0.01) and patient weight (β=0.13, p=0.01). Both use of the breakfast buffet (β=1.00, p=0.02) and the Delirium Observation Scale (β=-246.29, p=0.02) were related to higher energy intake.

Conclusions

In this pilot cohort study we cautiously conclude that the use of breakfast buffet significantly contributes to a higher protein and energy intake in patients. The breakfast buffet appeared to be a promising approach to optimize intake in gastrointestinal (oncological) hospitalized patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Amsterdam UMC.

Disclosure

All authors have declared no conflicts of interest.