What is the clinical evidence from this study?

Study design: Observational. Population: Gastrointestinal surgery (n=225). Intervention: Preoperative malnutrition vs. Well-nourished status. Primary outcome: Postoperative complications (OR 5.467, p=9.03E-06).

November 27, 2021Open Access

A Prospective Review of Preoperative Nutritional Status and Its Influence on the Outcome of Abdominal Surgery

Key Result

Preoperative severe malnutrition significantly increased the rate of postoperative complications to 63.38% compared to 26.62% in well-nourished patients undergoing abdominal surgery.

Study Design

Type

Observational (n=225)

Multicenter

Structured PICO

Does preoperative nutritional status predict postoperative complications in patients undergoing abdominal surgery?

Population

Patients undergoing abdominal surgeries in the urban private health care sector

Intervention

Preoperative nutritional assessment using absolute lymphocyte count (ALC), serum albumin, Subjective Global Assessment (SGA), BMI, mid-arm circumference (MAC), and triceps skinfold thickness (TSFT)

Outcome

Postoperative complication rate

Simple bedside nutritional assessment tools like serum albumin, absolute lymphocyte count, and SGA can accurately identify malnourished patients preoperatively and are good predictors of postoperative complications in abdominal surgery.

Main Result

Effect estimate: OR 5.467

Absolute Event Rate: 63.38% vs 26.62%

p-value: p=9.03E-06

Limitations

Small sample size
Includes both benign and malignant cases
Single center study, limiting generalizability
Emergency and elective surgeries were not analyzed separately

Abstract

analysis of the data, ALC, serum albumin, and SGA correlate with the postoperative complication rate with a p-value <0.05 as significant. On the contrary, BMI, MAC, and TSFT did not correlate with postoperative complications. Conclusion Preoperative malnutrition is common among patients undergoing abdominal surgeries in the urban private health care sector. Although there have been studies that have analyzed the incidence of malnutrition in patients undergoing oncological surgeries, there is limited literature on malnutrition among patients subjected to gastrointestinal surgeries. We conclude that simple bedside nutritional assessment tools like serum albumin, absolute lymphocyte count, and SGA can accurately identify malnourished patients preoperatively and are good predictors of postoperative complications. Hence, it is imperative to assess and attempt to improve the nutritional status of the patients preoperatively.

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