Assessment of Nutrition Status in Preoperative Surgical Patient Undergoing Major Abdominal Surgeries and Its Relation to Postoperative Outcome

Abstract

BACKGROUND Abdominal surgery represents a premeditated trauma, which leads to nutritional depletion and its possible related adverse outcomes, especially in malnourished pre-operative patients. Hence, the aim of the study was to assess nutritional status of a cohort of preoperative patients undergoing major gastrointestinal surgery and its relation to post-operative outcome using different nutritional indices. MATERIALS AND METHODS The present study was a prospective observational study. The study group consisted of total of 139 patients undergoing elective abdominal surgeries in the Department of Surgery in Guwahati Medical College and Hospital between 1 st July 2016 and 30 th June 2017. Nutritional status of all patients was assessed preoperatively with the help of nutritional tools such as PG-SGA, NRI, Serum Albumin, NRS 2002 and MUST. Patients were observed in the post-operative period for specific complications until the period of discharge (By one of the authors who was unaware of the pre-operative nutritional status). To assess the efficacy of the nutritional indices in predicting post-operative complications p value, chi-square, odds ratio, sensitivity, specificity, positive predictive value and negative predictive value were calculated wherever applicable. Study Design-Prospective observational study. RESULTS Out of the 139 patients studied, 6 patients died in early post-operative period due to various reasons. The remaining 133 patients were analysed out of which 49.6%, 53.8%, 36%, 81.9% and 50.4% were found to be malnourished according to PG-SGA, NRI, Serum Albumin, NRS 2002 and MUST respectively. Out of 133 patients, 70 were found to be free of complication. All the tools showed positive correlation on comparing the preoperative nutritional status and post complication rate with a p value < 0.0001 consistently.