de Assis Michelli Cristina Silva, Silveira Carla Rosane de Moraes, Beghetto Mariur Gomes, de Mello Daniel Elza
Universidade Federal do Rio Grande do Sul. Post-Graduate Program in Medical Sciences, School of Medicine. Porto Alegre, RS, Brazil. Hospital de Clínicas de Porto Alegre. Nutrology Division. Porto Alegre, RS, Brazil. Centro Universitário Unilasalle. Canoas, RS, Brazil..
Hospital de Clínicas de Porto Alegre. Nutrology Division. Porto Alegre, RS, Brazil..
Nutr Hosp. 2014 Oct 1;30(4):919-26. doi: 10.3305/nh.2014.30.4.7528.
Verify whether the postoperative fasting period increases the risk for infection and prolonged length of stay.
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.
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.
The longer duration of postoperative fasting was an independent risk factor both for infection and for prolonged hospital stay.
验证术后禁食期是否会增加感染风险和延长住院时间。
前瞻性队列研究。纳入择期手术患者。排除标准：无法进行营养评估者、入住最低护理病房者以及住院时间<72小时者。从无营养治疗的天数开始记录术后禁食情况。根据手术专科和类型，住院时间超过平均水平则视为延长。采用逻辑回归分析评估相关性并校正混杂因素。
共分析521例患者，44.1%禁食≥1天，91%禁食≥3天，5.6%禁食超过5天。禁食超过5天的患者营养状况更好，更多入住重症监护病房，术后手术并发症更多。校正混杂变量后发现，术后禁食≥1天感染风险增加2.04倍（95%置信区间：1.20至3.50），≥3天增加2.81倍（95%置信区间：1.4至5.8），禁食超过5天感染风险高2.88倍（95%置信区间：1.17至7.16）。禁食≥1天的患者延长住院风险为2.4倍（95%置信区间：1.48至3.77），≥3天和超过5天的患者分别为4.44倍（95%置信区间：2.0至9.8）和4.43倍（95%置信区间：1.73至11.3）。
术后禁食时间越长是感染和延长住院时间的独立危险因素。
