Nutrition Status is the Strongest Postoperative Complications Risk Predictor

Summary: Studies confirm that preoperative nutritional status is independent and one of the most significant risk factors for postoperative complications. This also means that preoperative nutrition therapy has a significant role in preventing post-surgical complications.

 Most people will have to undergo one or another surgery during their lifetime. Some make a brisk recovery, and many fail to regain prior strength and develop multiple post-surgical complications. 

So, why is there such a difference between the individuals?

New studies show that preoperative nutrition status is the single most important predictor of postoperative complications.

It is regretful that despite nutrition status playing such a vital role in surgical outcomes, it is also one of the neglected factors. Quite often, clinicians would not even test patients for their nutrition status. 

Most patients would be screened for diabetes and hypertension, told to avoid smoking and alcohol, and they might be treated for infections or provided antibiotic cover before surgery. However, nutrition therapy during the preoperative phase is rarely used to reduce the risk of postoperative complications.

Now, some of the new studies confirm that nutritional status is an independent risk factor. Not only that, it is also one of the most significant risk factors. Of course, we are talking about modifiable risk factors here. It means that nutritional status can be corrected by boosting the intake of certain nutrients before surgery, which may significantly reduce the risk of post-surgical complications.

Thus, for example, one of the studies on gastric surgery patients found that poor nutrition increased the risk of patients requiring intensive care by 36.8% and that of surgical site infections by 58.2%.

Things are even worse for some other kinds of elective surgeries, like hip surgery, which is more likely to occur in older adults. Studies show that malnutrition rates are close to 80% in this population group. Approximately one-fifth of complications would not occur in these patients if their nutritional status were corrected before surgery.

Further, studies show that poor nutritional status before surgery poses similar complications risk, such as excessive blood loss during surgery.

Poor nutritional status is associated with:

• Significantly increased complications risk
• Higher treatment costs
• Delayed wound healing
• Higher surgical site infection risks
• Much greater readmission risk
• Increased rehab costs

What is good about this issue is that it can be readily detected using some specific tests or preoperative screening tools. 

Moreover, it is worth noticing that older adults living with sarcopenia or muscle wasting and poor nutritional status are likely to benefit more than young adults. This means that this population group may benefit significantly from preoperative nutrition interventions.

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There are multiple reasons for malnutrition in surgical patients. Most of them may have chronic ailments and have increased requirements for specific nutrients.

However, there is also good news that nutritional status can be improved significantly in a few days to a few weeks. Experts recommend correcting the nutritional status of those undergoing elective surgery through dietary measures and health supplements.

Of course, dietary measures are essential. Thus, those planning to undergo surgery must consult a dietitian or may even ask their surgeon for specific recommendations. It is also worth understanding that correcting nutritional deficiencies using dietary measures alone is not always viable, so it may be a good idea to consider supplements.

There are a few ways to boost nutritional status. One should focus on increasing intake of vitamins and minerals, preferably through supplementation. Increase dietary intake of complex carbs to boost energy levels, and this can be done a few days before surgery. Finally, and most importantly, significantly boost your intake of proteins, and consider supplementing your diet with protein supplements and amino acids – as amino acids are essential for quick recovery.

Lastly, it is also worth understanding that 80% of surgeries are elective surgeries in the US. This means that 80% of the patients can correct their nutritional status before surgery. 

Preoperative nutrition therapy is about prevention, whereas postoperative nutrition therapy is merely about accelerating recovery. Prevention is always better. Hence, preoperative nutrition therapy is a must.