Decreased calorie and protein intake is a risk factor for infection and prolonged length of stay in surgical patients: A prospective cohort study

Abstract

Objective The aim was to assess whether postoperative calorie and protein intakes increase the risk of infection and prolonged length of stay in a tertiary care university hospital in Southern Brazil. Methods This is a prospective cohort study approved by the hospital's Research Ethics Committee. The sample consisted of adult patients undergoing elective surgery. The exclusion criteria included patients who could not undergo nutritional assessment and those with a planned hospital stay of fewer than 72 hours. Nutritional status was assessed on admission and every seven days thereafter until hospital discharge or death. Demographic and clinical data, as well as information regarding independent and outcome variables, were collected from the patient's records. Food intake assessment was conducted by researchers six times a week. Calorie and protein intakes were considered adequate if equal to or greater than 75% of the prescribed amount, and length of stay was considered prolonged when above the average for specialty and type of surgery. Data was analyzed using Poisson regression. Results Of the 519 study patients, 16.2% had adequate nutritional therapy. Most of these patients were men with ischemic heart disease and acquired immunodeficiency syndrome. After adjusting for confounders, inadequate nutritional therapy increased risk of infection by 121.0% (RR=2.21; 95%CI=1.01-4.86) and risk of prolonged length of stay by 89.0% (RR=1.89; 95%CI=1.01-3.53). Conclusion Most patients did not have adequate nutritional therapy. Those with inadequate nutritional therapy had a higher risk of infection and longer length of stay.

Determinants of Inadequate Calories Intake among Hospitalized Patients at Muhimbili National Hospital. A Cross-sectional Study in Dar es Salaam - Tanzania

“…The scarcity of studies highlights that not much has been researched regarding ICI in SSA and the need to conduct more research on this area in the region. However, studies in Malaysia and Brazil reported a very high proportion (more than 60%) of ICI (2,20) compared to our study. This difference might be due to methodological variations such as a smaller sample size used by the study in Malaysia and different inclusion criteria used in Brazil.…”

“…Although there is a lack of consensus on the clinical manifestations or markers of reduced calories consumption in patients, evidence from certain studies shows that people can have symptoms like hunger, fatigue, dry mouth, bowel irregularity, head and neck pain, nausea, and hair loss (16)(17)(18). This remains unclear, unless calories intake is screened using valid nutrition assessment methods, (2,19,20).…”

Evolução dos balanços energético e proteico no pós-operatório de pacientes submetidos a operações abdominais de grande porte

“…Quanto à ingestão proteica, não houve em nosso trabalho associação entre o BP e o tempo de internação ou complicações pós-operatórias. Foi observado, em um estudo anterior com pacientes cirúrgicos, importante inadequação do consumo energético e descritas associações com o aumento de infecções e maior tempo de internação 18 . Além disso, outro trabalho realizado com pacientes submetidos a gastrectomia sleeve evidenciou maior perda de massa magra e consequências associadas nos pacientes com significativa inadequação proteica 19 .…”

Programa de auxílio para alimentação de adultos hospitalizados: estudo quase-experimental

“…Contudo, a divisão das representações gráficas em quartis objetivou evitar vieses de subjetividade e já foram utilizadas por outros autores 11,24 . Com relação à ASG 25 , o método de avaliação nutricional utilizado nosso estudo, pode-se citar que este instrumento depende da memória do entrevistado, com relação a algumas perguntas.…”