Abstract

Author(s): Da Silva Nunes, Francisca Leide1; Ferreira Pinheiro Gadelha, Patrícia Calado2; De Souza Costa, Milena Damasceno3; Ribeiro de Amorim, Ana Carolina4; Gomes de Lima, Karla Vanessa5; Bezerra da Silva, Maria da Guia6

Introduction: Surgical patients are exposed to prolonged perioperative fasting can aggravate the metabolic response to trauma.

Objective: To identify the pre fasting period and after surgery and associate the incidence of postoperative complications and length of hospital stay in patients undergoing surgery of the gastrointestinal tract and abdominal wall.

Methods: This is a prospective observational study of hospitalized surgical patients from April to October 2013. It was considered the preoperative fasting time difference (in hours) of the last meal accomplished at the beginning of the surgical procedure. Postoperative fasting was recorded from the difference (in hours) between the end of the surgical procedure and the diet restart. Operations were divided into size I (operations involving abdominal wall and laparotomy without opening handles and/or manipulation of the bile ducts) and size II (operations involving laparotomy with open handles and/or manipulation of the bile ducts). Postoperative complications assessed for a period of 30 days after surgery. The time (in days) of postoperative hospital stay was calcuated as the difference between the date of discharge and the date of surgery. For data analysis we used the statistical software Sigma Stat 13.0, using the confidence level of 95%.

Results: There was no difference in median preoperative fasting time between the size of the surgeries I and II. Patients who underwent surgery sized II stayed longer in postoperative fasting (p <0.001) and in hospital longer (p <0.001). There was a higher percentage of complications in the size surgeries II (p = 0.001).

Discussion: Nutrition both pre and post-operative has an important role, reducing organic response to stress and interfering significantly to patient outcomes.

Conclusion: Preoperative fasting time was higher than the one from multimodal protocols of fasting abbreviation, regardless of surgical size. The extended perioperative fasting time may favor the increased length of hospital stay.