Clinical Research Directory

Impact of Nutritional Status Before Joint Replacement on Infection Risk

Periprosthetic joint infection (PJI) is a serious complication after joint replacement surgery and is difficult to treat. Poor nutritional status may impair the body's ability to recover and fight infection, as well as increase the risk of postoperative problems. The CONUT (Controlling Nutritional Status) score is a nutritional assessment tool that is based on 3 standard blood parameters, serum albumin, total cholesterol and total lymphocyte count. This study is a prospective observational study to investigate the association of preoperative nutritional status as defined by CONUT score and the risk of periprosthetic joint infection in patients undergoing joint arthroplasty. Preoperative nutritional assessment and postoperative follow-up will be performed to detect the occurrence of periprosthetic joint infection. We are studying whether a higher preoperative CONUT score is associated with a higher risk of infection after joint replacement surgery. The findings may help to identify those who are at increased risk of surgical infection and promote better preoperative assessment and patient care."

Nutritional Status in Patients With Chronic Kidney Disease Receiving 7.2% Amino Acids During Hemodialysis

Malnutrition and anemia are common among people with chronic kidney disease who receive maintenance hemodialysis. These conditions may worsen health outcomes and quality of life. Intradialytic parenteral nutrition (IDPN) provides nutrients through a vein during hemodialysis and may be used when dietary intake is not sufficient. However, evidence on IDPN containing only amino acids, particularly in adults undergoing hemodialysis in Indonesia, remains limited. This retrospective observational study will evaluate whether a 7.2% amino acid solution (KIDMIN®) given as IDPN is associated with improved nutritional status in adults with chronic kidney disease receiving maintenance hemodialysis. Medical records from Bangli Medika Canti Hospital covering July 2023 through December 2024 will be reviewed. Patients who received KIDMIN® during hemodialysis for at least 3 months will be compared with patients who did not receive IDPN. Both groups received the standard diet recommended for chronic kidney disease. The main outcome is the change in serum albumin level from baseline to Month 3. Other outcomes include serum albumin through Month 6, hemoglobin levels, nutritional status assessed using the Subjective Global Assessment, and quality of life assessed using the Kidney Disease Quality of Life questionnaire. No study-specific medication or additional invasive procedure will be administered because the study uses previously available clinical data.

Immunonutrition and Neuromonitoring for Postoperative Delirium in Gynecologic Oncology

Early postoperative delirium (POD) is a common and distressing neuropsychiatric complication frequently observed in elderly patients undergoing major surgical interventions, including radical and cytoreductive gynecologic oncological procedures (such as ovarian, cervical, and endometrial cancer surgeries). Delirium is associated with prolonged hospital and intensive care unit stays, functional decline, elevated healthcare expenditures, and increased perioperative morbidity. The pathogenesis of postoperative delirium is multifactorial, involving baseline patient vulnerability and intraoperative triggering factors. Malnutrition and systemic inflammation are recognized as critical predisposing factors that disrupt blood-brain barrier integrity and trigger neuroinflammatory cascades. The Controlling Nutritional Status (CONUT) score and the Naples Prognostic Score (NPS) are objective scoring systems combining nutritional biomarkers (serum albumin, total cholesterol) and immune-inflammatory markers (absolute lymphocyte count, neutrophil-to-lymphocyte ratio, and lymphocyte-to-monocyte ratio). Concurrently, intraoperative neuromonitoring (such as processed electroencephalography / bispectral index monitoring) provides continuous assessment of cerebral anesthetic depth and electrophysiological patterns like burst suppression, which have been implicated in acute cerebral dysfunction. The objective of this prospective observational study is to evaluate the individual and combined predictive utility of preoperative immunonutritional indices (CONUT and Naples Prognostic Score) alongside intraoperative neuromonitoring parameters for the occurrence of early postoperative delirium in elderly patients undergoing elective gynecologic oncological surgery.

Indirect Calorimetry-Guided Parenteral Nutrition Prescribing in Oncology Patients

This study compares two methods of prescribing parenteral nutrition (PN) in adults with cancer who are unable to meet nutritional needs by oral or enteral intake.

Combined Oral and Parenteral Nutritional Therapy After Gastrectomy for Gastric Cancer

Patients undergoing gastrectomy for gastric cancer frequently experience insufficient oral intake during the postoperative recovery period because of reduced gastric capacity, early satiety, and gastrointestinal symptoms. Although oral nutritional supplements (ONS) are commonly recommended, adherence is often poor, resulting in a postoperative nutritional gap. This prospective randomized clinical trial was designed to evaluate the impact of combined oral and parenteral nutritional therapy on nutritional status and recovery after gastrectomy for gastric cancer. Patients were randomized to either a combined nutritional therapy group receiving oral nutritional supplementation plus parenteral nutrition or a control group receiving standard postoperative care. The primary endpoint was postoperative body weight change at 4 weeks after surgery. Secondary endpoints included body composition, nutritional intake, inflammatory and immune markers, laboratory parameters, and quality of life outcomes.

Nutrition and Trauma - The Influence of Malnutrition in Geriatric Trauma Patients

Due to demographic changes, the geriatric patient population is growing, leading to a higher incidence of osteoporotic fractures associated with multimorbidity and frailty. Up to 60% of elderly patients are at risk of malnutrition, which is associated with a high rate of post-operative complications, prolonged hospitalisation, poorer return to independence and increased mortality. The NuTra study investigates the prevalence of malnutrition, evaluates screening tools and analyses the impact of protein-rich diets on postoperative outcomes in geriatric trauma. The aim is to develop evidence-based approaches to the prevention and treatment of malnutrition in order to improve the medical outcome and quality of life of geriatric trauma patients and reduce healthcare costs.