Analysis of Referrals to the Nutrition Support Team for Patients with Postoperative Enterocutaneous Fistula

Jeong, Mi Jin; Yu, Hee Chul; Hwang, Si Eun; Kim, Chan Young; Lee, Min Ro; Kim, Sun Haeng; Kim, Hyeong Seon; Kim, Ju Sin; Moon, Mi Kyung; Yoon, Wan Ki; An, Kyung Sook; Cho, Baik Hwan

Abstract

PURPOSE
The role of nutrition support for the management of enterocutaneous fistula is primarily one of supportive care to prevent malnutrition and thereby halt further deterioration of an already debilitated patient. This therapy is best managed by a nutritional support team (NST). For activation of the NST, physicians must become more aware of the need for nutrition support in patients, and so referrals are required from physicians. This study examined the referrals to the nutritional support team for patients with postoperative enterocutaneous fistula.
METHODS
Between March 2007 and May 2009, we reviewed 34 patients with postoperative enterocutaneous fistula and who was referred to the NST.
RESULTS
The mean age of the patients was 61.1+/-11.5 years. Twenty seven cases were males and 7 were females. The routes of nutrition support were EN+PN: 32 (55.2%), PN: 16 (27.6%), EN: 8 (13.0%) and oral intake +PN: 2 (3.4%). The direct referrals were 45 (77.6%) and the indirect referrals though the nutritional screening system were 13 (22.4%). The referrals for EN were 40 (69%) and those for PN were 18 (31.0%). The recommendations by the NST were accepted in 48 (82.8%) of the cases. The EN recommendations were accepted in all 40 (100.0%) of the cases. The PN recommendations by direct referral were accepted in 6 of 7 cases, but only 2 of 11 cases were accepted according to indirect referral.
CONCLUSION
More aggressive and thorough follow-up on whether or not to accept the NST recommendation is required. This study shows that regular scheduled nutrition support service orientations for the different staff and departments of the hospital should be held each year.