OBJECTIVES

: Sub-optimal nutritional status is a strong independent predictor of poor postoperative outcomes, particularly in patients undergoing major gastrointestinal (GI) surgery. A cost-effective way of reducing length of stay (LOS) in GI surgical patients is to provide perioperative nutrition to patients. The aim of our study is to estimate the cost savings associated with reduced LOS for GI surgical oncology patients who receive perioperative nutrition.

METHODS

: We utilized a subset of three randomized clinical trials from a meta-analysis (Marimuthu et al, 2012) examining the effect of immunonutrition in oncology patients undergoing major gastrointestinal surgery. The subset included only studies providing perioperative nutrition. The 2014 Healthcare Cost and Utilization Project data was used to calculate average costs for inpatient episodes involving surgical oncology procedures on the esophagus, stomach, colon, rectum, or pancreas. We estimated per patient cost savings by multiplying the LOS reduction associated with perioperative nutrition with the average inpatient episode cost (adjusted to 2018 dollars) and then subtracted the cost of perioperative nutrition.

RESULTS

: Data from Marimuthu et al (2012) demonstrates that perioperative nutrition resulted in a 14% reduction in LOS for GI surgical oncology patients. Based on an average episode cost of $28,198, we found a per patient savings of $3,891. Perioperative nutrition costs $57 per patient, resulting in an ROI of 68.7. There are approximately 117,540 inpatient surgical procedures for GI-related cancers per year in the US or a potential national cost savings of $457.4M.

CONCLUSIONS

: Perioperative nutrition can be a low-cost intervention in gastrointestinal oncology surgeries to reduce LOS and improve patient outcomes. More research is needed to examine perioperative nutrition’s impact on a range of surgeries (including GI surgery) to ascertain the impact of perioperative nutrition not only on LOS but also on post-operative complications, 30-day hospital readmissions, and total healthcare utilization.