Is duration of postoperative fasting associated with infection and prolonged length of stay in surgical patients?
被引:6
作者:
Silva de Assis, Michelli Cristina
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Univ Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
Hosp Clin Porto Alegre, Serv Nutrol, BR-90035003 Porto Alegre, RS, Brazil
Ctr Univ Unilasalle, Canoas, RS, BrazilUniv Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
Silva de Assis, Michelli Cristina
[1
,2
,3
]
de Moraes Silveira, Carla Rosane
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机构:
Hosp Clin Porto Alegre, Serv Nutrol, BR-90035003 Porto Alegre, RS, BrazilUniv Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
de Moraes Silveira, Carla Rosane
[2
]
Beghetto, Mariur Gomes
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Univ Fed Rio Grande do Sul, Dept Assistance & Profess Counseling, Porto Alegre, RS, BrazilUniv Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
Beghetto, Mariur Gomes
[4
]
de Mello, Elza Daniel
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Univ Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
Hosp Clin Porto Alegre, Serv Nutrol, BR-90035003 Porto Alegre, RS, BrazilUniv Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
de Mello, Elza Daniel
[1
,2
]
机构:
[1] Univ Fed Rio Grande do Sul, Posgrad Program Med Sci, Sch Med, Porto Alegre, RS, Brazil
[2] Hosp Clin Porto Alegre, Serv Nutrol, BR-90035003 Porto Alegre, RS, Brazil
[3] Ctr Univ Unilasalle, Canoas, RS, Brazil
[4] Univ Fed Rio Grande do Sul, Dept Assistance & Profess Counseling, Porto Alegre, RS, Brazil
Fasting;
Surgery;
Nutritional Status;
Infection;
Length of Stay;
OPEN COLORECTAL SURGERY;
HOSPITALIZED-PATIENTS;
ENTERAL NUTRITION;
MALNUTRITION;
PREVALENCE;
OUTCOMES;
D O I:
10.3305/nh.2014.30.4.7528
中图分类号:
R15 [营养卫生、食品卫生];
TS201 [基础科学];
学科分类号:
100403 ;
摘要:
Objective: Verify whether the postoperative fasting period increases the risk for infection and prolonged length of stay. Methods: Prospective cohort study. Elective surgery patients were included. Excluded: those with no conditions for nutritional assessment, admitted in minimal care units, as well as with <72h in-hospital stay. Postoperative fasting was recorded from the days of no nutrition therapy. The length of stay was considered prolonged when above the average according to the specialty and type of surgery. Logistic regression was used to assess associations and adjust for confounding factors. Results: 521 patients were analyzed, 44.1% were fasted for a period >= 1 day, 91% for >= 3 days and 5.6% for more than 5 days. Patients with more than 5 days fasting were more eutrophic, more admitted to intensive care units, and had more postoperative surgical complications. After adjustment for confounding variables, it was noted that >= 1 day of postoperative fasting increased the infection risk by 2.04 (CI95%: 1.20 to 3.50), >= 3 days 2.81 (CI95%: 1.4-5.8), and in fasting for more than 5 days the infection risk was 2.88 times higher (CI95%: 1.17 to 7.16). The risk for prolonged hospitalization was 2.4 (CI95%: 1.48 to 3.77) among patients who had >= 1 day fasting, 4.44 (CI95%: 2.0 to 9.8) and 4.43 times higher (CI95%: 1.73 to 11.3) among patients with >= 3 days fasting and more than 5 days, respectively. Conclusion: The longer duration of postoperative fasting was an independent risk factor both for infection and for prolonged hospital stay.