Abstract:

Background: Malnutrition is an emerging but neglected problem in hospitalized surgical patients and contributes significantly to adverse postoperative outcomes. Routine preoperative evaluation of nutritional status allows the identification of patients who are at risk of developing adverse postoperative outcomes and those who can benefit from nutritional therapy. However, at Bugando Medical Centre, patients scheduled for abnormal surgery are not routinely assessed for nutritional status. This study aimed to determine the prevalence of malnutrition and its association with early outcomes among patients undergoing abdominal surgery at Bugando Medical Centre, Mwanza, Tanzania.

Methods: This was a longitudinal study involving adult patients who underwent abdominal surgery at Bugando Medical Centre between January and June 2023. Nutritional status assessment was done according to the Nutrition Risk Scoring 2002 (NRS-2002) which is based on the amount of malnutrition, as defined by weight loss, food intake, and BMI, as well as on the severity of disease. A structured questionnaire was used to collect data and analysis was performed using Statistical of STATA version 15.0 software where p-value of <0.05 was used as a statistical level; of significance.

Results: A total of 303 patients were enrolled in the study. Their median age was 47 ± 17.5 years. There were 153 (50.5%) males and 150(49.5%) females. The overall prevalence of malnutrition was found to be 51.8% (157 303) over. Complication and mortality rates were 25.4% and 8.3%, respectively. The overall length of hospital stay ranged from 5 days to 14 days (median =9 days. Early postoperative problems were found to be statistically significantly associated with preoperative malnutrition. (OR=4.1, 95% CI [2.0-8.2], p-value< 0.001), prolonged length of hospital stays (OR=2.5, 95% CI [1.4-5.8], p-value = 0.003) and mortality (OR=4.6, 95%CI [2.5-11.2], p-value < 0.001). Furthermore, preoperative malnutrition significantly predicted surgical site infections (OR=2.2, 95% CI [1.0-4.8], p-value =0.047) and anastomotic leakage (OR=3.1, 95% [1.1-8.9], p-value =0.035).

Conclusion: This study demonstrated preoperative malnutrition is highly prevalent among adult patients undergoing abdominal surgery at Bugando Medical Centre and is a significant and independent factor for postoperative complications, mortality and increased length of hospital stay following abdominal surgery. This study emphasizes the need to routinely assess nutritional status using a validated tool preoperatively and drafting a nutrition care strategies to prevent malnutrition-related adverse postoperative outcomes.