Mapping nutrition management and assessment after pelvic exenteration surgery

Description of condition and exposure Pelvic exenteration (PE) is a radical surgical procedure involving en bloc resection of two or more adjacent pelvic organs for the treatment of locally advanced or recurrent gynaecological, urological, or colorectal malignancies. This surgery is associated with substantial physiological stress, prolonged recovery, and a high risk of malnutrition and nutrition-related complications. Nutri-MAP is a multicentre observational study examining real-world postoperative nutrition practices following PE surgery across Australia and New Zealand. The exposure of interest is usual care nutrition management following PE, including nutrition screening, assessment, prescription, route of nutrition delivery, and monitoring, as determined by the treating clinical team. What participation involves Participants do not receive any study-mandated nutrition intervention, and all medical and nutrition care is delivered according to standard clinical practice. Participation involves consent for the collection of routinely recorded clinical data, as well as completion of standard nutrition assessments performed by a dietitian at defined timepoints. Assessments are conducted during routine clinical encounters, including the usual pre-operative outpatient appointment and bedside during hospital admission. Assessments performed Participants will undergo the following nutrition-related assessments at three timepoints: pre-operative (baseline), two weeks post-surgery, and at hospital discharge: - Patient-Generated Subjective Global Assessment (PG-SGA) malnutrition assessment (anticipated completion time approximately 10–15 minutes) - Hand grip strength measurement (approximately 2–3 minutes) - Mid-upper arm circumference (MUAC) measurement (approximately 1–2 minutes) - Calf circumference measurement (approximately 1–2 minutes) These assessments are within the scope of routine dietetic practice but are collected systematically for research purposes as part of this study. No biological samples are collected. Other data collected Additional data collected from the medical record include demographic information, surgical and clinical details, nutrition prescriptions (oral, enteral and/or parenteral nutrition), estimated energy and protein provision, and relevant postoperative outcomes routinely captured during inpatient care. Duration of observation Participants are observed from their pre-operative assessment through their postoperative inpatient admission following pelvic exenteration surgery. Clinical and nutrition-related data are collected during the index hospital admission. Readmission events occurring within 30 days of the index hospital admission are identified through review of routinely collected medical records. No additional participant contact or study visits are required beyond standard clinical care.