Purpose <p>To assess the impact of personalized nursing care plans, based on the modified abPG-SGA, on postoperative nutritional status in patients undergoing colorectal cancer surgery.</p> Methods <p>A retrospective cohort analysis was conducted on clinical data from colorectal cancer surgical patients admitted to a single center. Patients were divided into a routine nursing care group and a personalized nursing care group assessed under the modified abPG-SGA. Inclusion and exclusion criteria were defined, and nursing methods, data collection, and statistical analysis were detailed. Various parameters including demographic features, disease characteristics, surgical outcomes, gastrointestinal complications, postoperative complications, nutritional markers, dietary intake, serum electrolyte levels, length of hospital stay, and functional recovery were compared between the two groups. Based on the composite nutritional score, patients in the personalized care group were stratified into three risk grades, guiding the intensity of nutritional support. Clinical response to intensive support was assessed within 7 days post-intervention. Statistical analysis included independent-samples t-test, chi-square test, and multivariable logistic regression models adjusting for age, BMI, sex, ASA score, comorbidities (hypertension, diabetes, hyperlipidemia), tumor location, and treatment time period.</p> Results <p>The personalized nursing care group showed significantly improved bowel function recovery time, reduced incidence of postoperative wound infection and urinary tract infection, improved nutritional markers and dietary intake, and maintenance of specific serum electrolyte levels compared to the routine nursing care group. Additionally, the personalized nursing care plans were associated with a reduction in the length of hospital stay and improved postoperative recovery parameters. Furthermore, risk stratification using the modified abPG-SGA demonstrated strong alignment with the intensity of nutritional support and predicted clinical response, with higher-risk patients exhibiting greater improvement. Multivariable regression analysis confirmed that personalized nursing care was independently associated with significantly lower odds of surgical site infection (adjusted OR = 0.26, 95% CI: 0.08–0.85, <i>P</i> = 0.025) and urinary tract infection (adjusted OR = 0.17, 95% CI: 0.03–0.79, <i>P</i> = 0.022), as well as a significant reduction in hospital stay (adjusted β = -1.92 days, 95% CI: -3.31 to -0.53, <i>P</i> = 0.007). Furthermore, personalized nursing care independently predicted improved postoperative prealbumin levels (adjusted β = 29.1&#xa0;mg/L, 95% CI: 9.5–48.7, <i>P</i> = 0.004) and serum protein levels (adjusted β = 3.9&#xa0;g/L, 95% CI: 1.1–6.7, <i>P</i> = 0.007) after adjustment for confounders.</p> Conclusion <p>Personalized nursing care plans based on the modified abPG-SGA were associated with improved postoperative nutritional status and recovery outcomes in patients undergoing colorectal cancer surgery. However, due to the non-randomized retrospective design, causal inference cannot be made, and findings should be interpreted as associations. Further prospective randomized controlled trials are warranted to confirm these findings.</p>