Fachini Caroline, Alan Claudio Z, Viana Luciana V
Critical Care Unit, Hospital Casa de Misericórdia, Rua Prof. Annes Dias, Porto Alegre, RS, 295, Brazil.
Critical Care Unit, Hospital Mãe de Deus, Rua José de Alencar, Porto Alegre, RS, 286, Brazil.
Perioper Med (Lond). 2022 Aug 2;11(1):29. doi: 10.1186/s13741-022-00261-4.
Cancer patients present nutritional and complications risks during the postoperative period. Fasting contributes to surgical catabolic damage. This study evaluates the consequence of fasting time on the surgical outcomes of cancer patients undergoing elective surgeries.
Prospective cohort, evaluating two categories of patients according to postoperative fasting: less than or greater than 24 h.
Hospitalization time, 28-day mortality, ICU stay and infection rates.
We included 109 patients (57% men, 60 ± 15 years, BMI: 26 ± 5 kg/m, SAPS3 43 ± 12), hepatectomy was the most frequent surgery (13.8%), and colon and rectum were the most common neoplasia (18.3%). The ICU stay was longer in postoperative fasting > 24 h (5.5 [4-8.25] vs. 3 [2-5] days, p < 0.001). Fasting > 24 h persisted as a risk factor for longer length of stay (LOS) in the ICU after adjustments. There were no differences in the mortality analysis within 28 days and total hospitalization time between groups. A tendency to experience more infections was observed in patients who fasted > 24 h (34.8% vs. 16.3%, p = 0.057). Onset of diet after the first 24 h postoperatively was a risk factor for longer ICU stay in cancer patients who underwent major surgeries.
癌症患者在术后存在营养和并发症风险。禁食会导致手术分解代谢损伤。本研究评估禁食时间对接受择期手术的癌症患者手术结局的影响。
前瞻性队列研究，根据术后禁食情况将患者分为两类：少于或多于24小时。
住院时间、28天死亡率、重症监护病房（ICU）住院时间和感染率。
我们纳入了109例患者（男性占57%，年龄60±15岁，体重指数[BMI]：26±5kg/m²，简化急性生理学评分系统[SAPS3]43±12），肝切除术是最常见的手术（13.8%），结肠和直肠是最常见的肿瘤（18.3%）。术后禁食>24小时的患者ICU住院时间更长（5.5[4 - 8.25]天 vs. 3[2 - 5]天，p<0.001）。调整后，禁食>24小时仍是ICU住院时间延长的危险因素。两组间28天内的死亡率分析和总住院时间无差异。禁食>24小时的患者有发生更多感染的趋势（34.8% vs. 16.3%，p = 0.057）。术后24小时后开始进食是接受大手术的癌症患者ICU住院时间延长的危险因素。
