Patients who undergo several orthopedic surgeries in hospitals face a high risk of malnutrition, which can delay recovery and cause death, according to a study of more than 28 million patients.
Before surgery, most patients are advised to fast for at least eight hours and only consume clear liquids up to two hours before the operation. For those who require multiple surgeries during a hospital stay, especially within a few days, prolonged or repeated fasting can exacerbate the risk of malnutrition.
A study analyzed records of more than 28 million patients who underwent orthopedic surgery in a hospital between 2016 and 2019, the American Society of Anesthesiologists said in an Oct. 19 news release.
About 6% were diagnosed with malnutrition after admission, and among these 1.8 million patients, they faced higher hospital costs, longer stays and were at least 15% more likely to die compared to those who were not malnourished. The mortality risk increased with more surgeries.
Patients who were not malnourished had an average of 1.57 surgeries, 4.3 days in a hospital and a $48,000 hospital bill. Those who were malnourished had an average of 2.31 surgeries, 9.1 days in a hospital and a $98,000 bill.
"While fasting is a crucial part of ensuring patients' safety during surgery, our findings suggest modifications to clinical practice should be considered for patients who are at risk for malnourishment — such as those who are older than 65, have a chronic illness like diabetes or congestive heart failure or have limited access to adequate nutrition prior to surgery for socioeconomic reasons," Ivie Izekor, lead author of the study, said in the release.
The cause of death in malnourished patients was typically associated with infection, complications from poor wound healing or general frailty.
To prevent malnutrition, researchers recommend personalized nutrition support for patients undergoing multiple surgeries.