The Impact Of Preoperative Nutritional Status On Postoperative Recovery In Major Abdominal Surgery

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Dr. Venkata Sandeep Menta, Dr. Srikanth Marthandam, Dr. Gopikrishna B., Dr. Harshavardhan Vangara

Abstract

Background: Malnutrition is prevalent among surgical patients and may significantly impact postoperative outcomes. This study aimed to investigate the association between preoperative nutritional status and postoperative recovery in patients undergoing major abdominal surgery.


Methods: In this prospective, observational cohort study, 250 patients scheduled for elective major abdominal surgery were enrolled. Preoperative nutritional status was assessed using the Subjective Global Assessment, anthropometric measurements, biochemical markers, and bioelectrical impedance analysis. Patients were classified as well-nourished, moderately malnourished, or severely malnourished. The primary outcome was the incidence of postoperative complications within 30 days. Secondary outcomes included length of hospital stay, time to first flatus, pain scores, 30-day readmission rates, and quality of life.


Results: Of the 250 patients, 40% were well-nourished, 40% moderately malnourished, and 20% severely malnourished. The overall complication rate was 35.2%, with significant differences among nutritional status groups (well-nourished: 20%, moderately malnourished: 40%, severely malnourished: 56%; p<0.001). Severe malnutrition was an independent predictor of postoperative complications (adjusted OR 3.2, 95% CI 1.8-5.7, p<0.001). Malnourished patients had significantly longer hospital stays, delayed return of bowel function, higher pain scores, increased readmission rates, and poorer quality of life scores at 30 days post-surgery (all p<0.001).


Conclusion: Preoperative malnutrition is strongly associated with adverse postoperative outcomes in patients undergoing major abdominal surgery. These findings underscore the importance of routine preoperative nutritional assessment and suggest that targeted nutritional interventions may improve surgical outcomes.

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