Association between nutrition-focused evidence-based nursing and post-operative nutritional status in patients undergoing colorectal cancer surgery

Abstract

Background Patients undergoing colorectal cancer surgery are at risk of postoperative nutritional deterioration due to perioperative metabolic stress, inflammation, and transient gastrointestinal dysfunction. Evidence-based, nursing-led nutritional pathways may improve perioperative nutritional surveillance and timely nutrition support. Methods This retrospective study included 214 adults who underwent elective curative-intent colorectal cancer resection between January 2023 and December 2024. Patients receiving routine perioperative nursing care in 2023 were assigned to the control group (n = 106), whereas those receiving the nutrition-focused evidence-based nursing protocol in 2024 were assigned to the observation group (n = 108). The primary outcomes were change in Nutritional Risk Screening 2002 (NRS-2002) score and postoperative nutritional risk, defined as NRS-2002 ≥ 3 at postoperative day 7 or immediately before discharge. Results Baseline characteristics were comparable between groups. The observation group had lower postoperative NRS-2002 scores and smaller ΔNRS-2002 than the control group (both P < 0.001). Postoperative nutritional risk was also lower in the observation group (44.4% vs. 67.0%, P = 0.001). After multivariable adjustment, the observation group remained associated with lower odds of postoperative nutritional risk (adjusted odds ratio = 0.17, 95% confidence interval: 0.08–0.36; P < 0.001). Secondary findings showed less weight loss, smaller declines in albumin and prealbumin, lower discharge C-reactive protein, earlier feeding recovery, shorter postoperative hospital stay, fewer overall complications, and fewer nutrition-support–related safety events. Conclusions A nutrition-focused evidence-based nursing protocol was associated with more favorable postoperative nutritional risk status assessed by NRS-2002, as well as selected short-term recovery- and safety-related outcomes after colorectal cancer surgery. These findings should be interpreted as associative and require confirmation in prospective studies.