Abstract
During a surgical procedure, patients are often subjected to fasting for times that are more prolonged than the ideal, which may lead to complications. To evaluate the duration of perioperative fasting and its association with postoperative complications, length of hospital stay (LOS) and mortality among gastric and colorectal cancer patients. Cohort study developed in a surgical oncology hospital in the city of Natal (Rio Grande do Norte, Brazil). Patients aged over 18 years were included. The Clavien-Dindo surgical complication scale was used to evaluate occurrences of postoperative complications. LOS was defined as the number of days for which patients stayed in the hospital after surgery, or until the day of death. Seventy-seven patients participated (59.8 ± 11.8 years; 54.5% females; 70.1% with bowel tumor). The incidences of postoperative complications and death were 59.7% and 3.9%, respectively. The duration of perioperative fasting was 59.0 ± 21.4 hours, and it was higher among non-survivors and among patients with prolonged hospital stay (≥ 6 days). For each one-hour increase in the durations of perioperative and postoperative fasting, the odds of prolonged hospitalization increased by 12% (odds ratio, OR = 1.12; 95% confidence interval, CI 1.04-1.20) and 5% (OR = 1.05; 95% CI 1.02-1.08), respectively. Prolonged perioperative fasting, especially in the postoperative period, was observed in a sample of patients with gastric and colorectal cancer, and this was an independent predictor of LOS.
Highlights
Gastrointestinal cancers, including cancers of the esophagus and stomach, colon and rectum, liver, gallbladder, pancreas, small intestine, appendix and anus, collectively represent one of the greatest public health issues, given that they lead to almost 4.5 million deaths worldwide per year.[1]
A total of 140 patients were initially screened before surgery, but 63 of them were excluded because their data regarding the duration of pre or postoperative fasting were incomplete
Death occurred in the case of three individuals, of whom two were colorectal cancer patients
Summary
Gastrointestinal cancers, including cancers of the esophagus and stomach, colon and rectum, liver, gallbladder, pancreas, small intestine, appendix and anus, collectively represent one of the greatest public health issues, given that they lead to almost 4.5 million deaths worldwide per year.[1]. Patients are often subjected to fasting for times that are more prolonged than the ideal, which may lead to complications. OBJECTIVE: To evaluate the duration of perioperative fasting and its association with postoperative complications, length of hospital stay (LOS) and mortality among gastric and colorectal cancer patients. The duration of perioperative fasting was 59.0 ± 21.4 hours, and it was higher among non-survivors and among patients with prolonged hospital stay (≥ 6 days). For each one-hour increase in the durations of perioperative and postoperative fasting, the odds of prolonged hospitalization increased by 12% (odds ratio, OR = 1.12; 95% confidence interval, CI 1.04-1.20) and 5% (OR = 1.05; 95% CI 1.02-1.08), respectively. CONCLUSION: Prolonged perioperative fasting, especially in the postoperative period, was observed in a sample of patients with gastric and colorectal cancer, and this was an independent predictor of LOS
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