Differences in nutrition provision in patients with or without open abdomen: a retrospective cohort study of patients with enterocutaneous fistula

Background: Ideal nutrition provision in the first week of critically ill surgical patients is not well understood. Patients with open abdomen have a high nutrition demand, and this patient population is at considerable risk of enterocutaneous fistula development. This study aimed to assess the differences in nutrition provision in patients with or without an open abdomen and known development of enterocutaneous fistula. Methods: This retrospective study consisted of a cohort of enterocutaneous fistula patients from 2019-2022. After inclusion criteria were met, patients were divided in two groups: those with open abdomen and those without. Patient electronic medical records were examined to assess the percentage of nutrition provision in the first week of hospital stay, and researchers aimed to establish if goal nutrition (>60% estimated needs) was delayed in the open abdomen group. Secondary outcomes included length of stay, ICU length of stay, and nutrition status at discharge. Results: 45 patients were included in this study, 17 patients with open abdomen and 28 patients without. There were no statistical differences in hospital day to achieve goal nutrition or percentage of target nutrition received in the first six days. There was a weak to moderate correlation between nutrition provision and length of stay and ICU length of stay. The open abdomen cohort had a significantly longer ICU length of stay and a greater decline in nutrition status during hospital admit. Conclusion: There was no statistical difference in nutrition provision during the first six days of hospital admission between open abdomen and non-open abdomen patients with known enterocutaneous fistula development.