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NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Improving Surgical Outcomes with Immunonutrition Organization Overview • Nestlé Health Science is engaged in advancing the therapeutic role of nutrition in health management • The company operates in around 40 countries with around 3,000 employees • Nestlé Health Science plays a key role in the Nestlé Group, in its quest to expand the boundaries of nutrition, health, and wellness Background Surgical complications create suboptimal healthcare outcomes by increasing hospital readmission risks for patients and contributing billions of dollars in avoidable healthcare costs each year: • The risk of 30-day readmission after general surgery increases 4 times when a complication occurs, and one of the most common complications is surgical site infection 1 • One in four colon resection patients are readmitted to the hospital within 90 days 2 • Soft tissue surgical site infections alone contribute $1.6 billion in direct costs annually 3 1 Kassin et al. Risk factors for 30-day hospital readmission among general surgery patients. J Am Coll Surg 2012;215:322-330. 2 Wick EC et al. Readmission rates and cost following colorectal surgery. Dis Colon Rectum 2011;54(12):1475-9. 3 deLissovoy G et al. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009;37:387-397. To combat these avoidable outcomes, Nestlé Health Science focuses on developing innovative therapeutic nutrition products that meet the unique nutritional demands that major surgery places on the body to help reduce the risk of post-surgical complications. Product Details • Nestlé Health Science has developed the IMPACT ® family of formulas to provide therapeutic nutrition to surgery patients, through a unique combination of immunonutrients, including arginine, omega-3 fatty acids and dietary nucleotides, that support immune response 4 • The products are available in oral and tube-fed forms • Positive clinical outcomes associated with IMPACT ® products have been demonstrated in over 40 publications across many types of surgeries, including GI cancer, head and neck cancer, cardiothoracic, bladder cancer, orthopedic, and gynecological cancer 5,6,7 4 Braga M et al. Immunonutrition: from laboratory to clinical practice. Nutr 2007;23:368-370. 5 Drover JW et al. Perioperative use of arginine-supplemented diets: a systematic review of the evidence. J Am College Surgeons Mar 2011: 212(3): 385-399. 6 Alito Aprelino M and de Aguilar-Nascimento JE. Multimodal Perioperative Care plus Immunonutrition versus Traditional Care in Total Hip Arthroplasty: A Randomized Pilot Study. Nutrition Journal 2016;15:1-7. 7 Bertrand J et al. Impact of Preoperative Immunonutrition on Morbidity following Cystectomy for Bladder Cancer: A Case-Control Pilot Study. World J Urol 2014;32:233-237. An Initiative of the 83 | Improving Surgical Outcomes with Immunonutrition
NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Value Delivered In elective surgery patients, the IMPACT ® family of formulas has demonstrated the following reductions in risk: 8 • Abdominal abscesses, by 54% • Urinary tract infections, by 47% • Anastomotic leaks, by 44% • Surgical site infections (SSIs), by 37% • 2-3 day decrease in length of stay (LOS) Health economics research has been published estimating the potential cost savings of implementing IMPACT ® immunonutrition in GI cancer surgeries. For a base complication rate of 20.8%, the use of IMPACT ® formulas peri-operatively is estimated to save the healthcare system approximately $2192 per patient stay. 9 Path Forward • Nestlé Health Science is committed to advancing its breakthrough nutritional therapies in other areas, including Inherited Metabolic Disorders, Pediatric Care, Acute Care, Obesity Care, and Diabetic Neuropathy • Nutritional therapies have the potential to change the course of a patient’s condition, and Nestlé Health Science is committed to making nutritional therapies a more central part of the care management process 8 Waitzberg DL et al. Postsurgical infections are reduced with specialized nutrition support. World J Surg 2006;30:1592-1604. 9 Mauskopf JA et al. Immunonutrition for patients undergoing elective surgery for gastrointestinal cancer: impact on hospital costs. WJSO 2012:10:136. IMPACT ® and IMPACT Advanced Recovery ® are registered trademarks of Société des Produits Nestlé S.A., Vevey, Switzerland Improving Surgical Outcomes with Immunonutrition | 84
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