What influences emergency general surgeons' treatment preferences for patients requiring nutritional support? A discrete choice experiment

IF 2.9 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Colorectal Disease Pub Date : 2025-04-15 DOI:10.1111/codi.70081

Daniel L. Ashmore, Jenna L. Morgan, Timothy R. Wilson, Vanessa Halliday, Matthew J. Lee

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引用次数: 0

Abstract

Aim

Identifying and managing malnourished emergency general surgery (EGS) patients can be difficult. There are many tools available, a range of barriers to overcome and variety of guidelines at a surgeon's disposal. This study aimed to determine the impact of key variables on surgeon preference to start nutritional support in EGS.

Methods

A discrete choice experiment was used to determine the impact of six variables on surgeons' treatment preferences for commencing nutritional support in EGS. Twenty-five hypothetical scenarios regarding a patient with adhesional small bowel obstruction were disseminated electronically. Binomial logistic regression was used to identify significant associations. Ethical approval was obtained (UREC 050436).

Results

In all, 148 participants responded providing 3700 scenario responses. Completion rate was 52.1% (148/284) with an approximately even split of consultants and non-consultants (50.7% vs. 49.3%) and intestinal failure (IF) experience (46.6% experienced vs. 53.4% not experienced). Consultants favoured starting nutritional support (77.7%; 1443/1875) more often than non-consultants (71.8%; 1310/1825). Forming an anastomosis, hypoalbuminaemia, underweight (body mass index <18.5 kg/m²), unintentional weight loss (>10%), ≥5 days without oral intake until now and ≥5 days likely to be without oral intake from now were statistically more likely to be associated with treatment preference, but obesity (body mass index >30 kg/m²) was not. Overall, experience of IF (OR 1.093, 95% CI 0.732–1.631; P = 0.663) and seniority of surgeon (OR 0.711, 95% CI 0.473–1.068; P = 0.100) significantly influenced the results.

Conclusions

There are many variables that impact the decision to start nutritional support in EGS, but seniority of the surgeon and IF experience do not.

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来源期刊

Colorectal Disease 医学-胃肠肝病学

CiteScore

6.10

自引率

11.80%

发文量

406

审稿时长

1.5 months

期刊介绍： Diseases of the colon and rectum are common and offer a number of exciting challenges. Clinical, diagnostic and basic science research is expanding rapidly. There is increasing demand from purchasers of health care and patients for clinicians to keep abreast of the latest research and developments, and to translate these into routine practice. Technological advances in diagnosis, surgical technique, new pharmaceuticals, molecular genetics and other basic sciences have transformed many aspects of how these diseases are managed. Such progress will accelerate. Colorectal Disease offers a real benefit to subscribers and authors. It is first and foremost a vehicle for publishing original research relating to the demanding, rapidly expanding field of colorectal diseases. Essential for surgeons, pathologists, oncologists, gastroenterologists and health professionals caring for patients with a disease of the lower GI tract, Colorectal Disease furthers education and inter-professional development by including regular review articles and discussions of current controversies. Note that the journal does not usually accept paediatric surgical papers.