Health
Excessive Fasting May Harm Orthopedic Surgery Patients in Hospital
October 21, 2024
Multiple surgeries during a prolonged hospital stay can lead to malnutrition due to repeated fasting, thus increasing the risk of death and slowing down recovery for such patients. This is according to a new study that warns against the harmful effects of continuous fasting required for multiple surgical procedures.
Patients scheduled for surgery are typically advised not to eat after midnight before their procedure. This is done in an attempt to decrease the likelihood of vomiting during general anesthesia and deep sedation. However, this practice becomes detrimental when patients have several surgeries within one hospitalization period, as it leads to malnutrition.
The research was led by Ivie Izekor, a fourth-year medical student at Texas A&M College of Medicine. "Our research determined that repeated fasting in hospitalized patients having multiple orthopedic surgeries over days or weeks increases the risk for protein-calorie malnutrition, leading to longer hospital stays, slower recovery, and higher health care costs," said Izekor.
In order to conduct this study, data from approximately 28.5 million patients who underwent any type of orthopedic surgery between 2016 and 2019 was examined. Out of these individuals, more than 1.8 million were diagnosed with malnutrition following admission into the hospital.
It was discovered that those diagnosed with malnutrition had undergone more surgeries during their stay, averaging about 2.3 operations per stay compared with nearly 1.6 procedures among those who did not become undernourished.
Malnourished individuals also faced dire consequences, as they were found to be 15% more likely to die—a risk that increased significantly if they underwent additional surgical interventions. These unfortunate victims usually succumbed due to infection complications arising from poor wound healing or overall frailty exacerbated by nutritional deficiency.
Furthermore, these people incurred higher healthcare costs (an average of $98k versus $48k) and endured longer periods in hospitals (nine days on average compared with four).
These findings were presented at the American Society of Anesthesiologists annual meeting held in Philadelphia. However, they should be considered preliminary until published in a peer-reviewed journal.
To combat this issue, researchers recommend that patients who require multiple surgeries during one hospital stay receive personalized nutritional support. This could involve dietary assessments, the provision of nutritional supplements, and monitoring of their nutritional status to facilitate faster recovery and reduce complications.
Dr. George Williams, senior researcher and professor/vice chair of critical care medicine with McGovern Medical School at UT Health in Houston, emphasized that repeated fasting combined with surgical stress can compromise the patient's nutrition irrespective of the type of surgery involved.
However, he also noted that it might be more challenging to establish cause-and-effect relationships in gastrointestinal surgeries due to their direct impact on digestive systems.
In conclusion, before embarking on multiple surgeries within one hospitalization period, patients are advised to inquire about how doctors plan on supporting their proper nutrition throughout the process.
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