{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:34:15Z","timestamp":1792064055953,"version":"4.4.0"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National High Level Hospital Clinical Research Funding","award":["BJ-2022-152"],"award-info":[{"award-number":["BJ-2022-152"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["BJ-2024-215"],"award-info":[{"award-number":["BJ-2024-215"]}]},{"name":"National High Level Hospital Clinical Research Funding","award":["BJ-2022-114"],"award-info":[{"award-number":["BJ-2022-114"]}]},{"name":"Science and Technology Innovation Project for Medicine and Health of the Chinese Academy of Medical Sciences","award":["2021-12M-C&T-B-094"],"award-info":[{"award-number":["2021-12M-C&T-B-094"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditional perioperative care is hospital-centric, whereas the efficacy of multidisciplinary team (MDT)-based comprehensive nutrition management remains debated. This study examines how this model impacts postoperative complications and functional recovery in older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A single-center superiority randomized controlled trial (RCT; April 2023\u2013March 2024) randomized 120 older adults (\u226565y) undergoing major abdominal surgery (grades 3\u20134) into intervention (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f60) and control (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f60) groups, excluding those with severe organ dysfunction or poor compliance. The MDT-based model included personalized exercise, nutrition, psychological support (3 weekly sessions, smoking\/alcohol cessation), and post-discharge monitoring via wearables\/WeChat. Control group received standard care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 120 participants (mean age 72.6\u202fyears; 65.2% male), 5 were lost to follow-up, leaving 56 in the intervention group and 59 in the control group for analysis. The intervention group demonstrated significantly lower postoperative complications compared to controls, with a relative reduction in in-hospital events and lower post-discharge rates (3.6% vs. 6.8%). The Comprehensive Complication Index averaged 6.2 points lower in the intervention group (\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.175). Body composition improved significantly, showing reduced weight loss, reduced BMI loss, and increased appendicular skeletal muscle mass index. Postoperative hospital stay was shortened by a median of 3.67\u202fdays in the intervention group, which also reported higher rates of mobility improvement and pain relief (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The MDT-based perioperative model synergistically reduces postoperative complications and accelerates geriatric functional recovery through nutritional, exercise, and psychological interventions, providing evidence-based support for high-risk elderly care.<\/jats:p>\n                  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