Impact of malnutrition on the clinical evolution in a cohort of older patients undergoing emergency surgery for abdominal pathology

Abstract

Purpose

Analyse the influence of the nutritional status of older patients undergoing emergency abdominal surgery on postoperative complications, mortality and mean length of hospital stay.

Methods

We performed a longitudinal observational study including patients older than 80 years who underwent emergency surgery by the general surgery service for abdominal pathology, who were followed by the geriatrics service between September 2018 and May 2021. Malnutrition was diagnosed using Global Leadership Initiative on Malnutrition (GLIM) criteria, classifying patients as malnourished and normonourished. A comprehensive geriatric assessment was performed on patients, and postoperative complications, mean length of hospital stay and mortality in-hospital were recorded.

Results

131 patients were included, 84 of them were malnourished and 47 normonourished. Mean age was 86 ± 4.7 years. Malnourished patients had higher incidence of new-onset atrial fibrillation (odds ratio [OR]: 6.1, 95% confidence interval [CI]: 1.33–27.6, p < 0.05), urinary tract infection (OR 4.72, 95% CI: 1.02–21.95, p < 0.05) and bacteraemia (OR 3.51, 95% CI: 1.14–11.1, p < 0.05), compared with normonourished patients. Surgical complications were more frequent in malnourished patients (OR 3.34, 95% CI: 1.5–7.44, p < 0.05). Mean length of hospital stay in malnourished patients was longer (22.6 (±14.1)) compared with normonourished patients (15.3 (±11.9)) (p < 0.005).

Conclusion

Malnutrition in older patients (mean age 86 years old) undergoing emergency abdominal surgery is associated with a poorer clinical course; thus, it must be considered in the evaluation and follow-up of these patients.