The objective of this study was to determine the incidence and predictors of mortality during postoperative fasting (POF) in conventional digestive surgery.
Methods: This was a prospective, multicenter and interventional cohort study before and after surgery carried out in 3 hospitals in Kinshasa from January 2 to September 30, 2016.
Results: Of 303 operated patients included, 51% were men. The average age of those operated on was 35.1 ± 9.6 years. The frequency of weight loss (body mass index (BMI) <18.5 kg / m²) was 22.4% before surgery and 36.6% after. The mean duration of POF was 5.3 ± 1.9 days (JS) and the hospital stay ≥14 JS in 55.8% of operated patients with 7.3% of deaths in the series. In univariate analysis, female gender, excess alcohol, physical inactivity (PI), postoperative peritonitis (PPO) (HR = 3.2IC95% 1.6-6.5; p <0.001), surgical site infection, late oral feeding (LOF) and age ≥60 years were predictors of mortality. While in the Cox multivariate regression, only the female sex (HR = 4.4 CI 95% 1.2-15.5; p = 0.023), the PI (HR = 6.1 CI 95% 2.4-15, 5; p <0.0001), postoperative peritonitis (POP) (HR = 3.2 95% CI 1.6-6.5; p <0.001) and AOT (HR = 5 95% CI 2.5-10.4; p <0.0001) were the significant predictors of mortality.
Conclusion: In view of the worsening of the leanness and the extent of mortality in this work, preoperative measures aimed at correcting undernutrition and alcohol withdrawal, promoting early oral post-operative feeding and the practice of l exercise is necessary especially in the elderly and women.