The impact of preoperative nutrition status on abdominal surgery outcomes: A prospective cohort study

Background The European Society for Clinical Nutrition and Metabolism recommends nutrition screening using the Mini Nutritional Assessment Short‐Form (MNA‐SF) in older adult patients preoperatively. However, the association of nutrition condition with postoperative complications is poorly documented. We aimed to identify preoperative nutrition status using the MNA‐SF and to determine whether preoperative nutrition status affects postoperative outcomes. Methods Inpatients aged ≥55 years who underwent elective abdominal surgery under general anesthesia between April 1, 2016, and December 28, 2018, were included. We assessed nutrition status using the MNA‐SF before surgery. Multiple logistic regression including the MNA‐SF score was applied to determine associated factors with our primary outcome, postoperative complications defined as Clavien‐Dindo classification ≥3a. Secondary outcomes including length of hospital stay and unplanned readmission were compared between normal, at risk, and malnourished patients. Results The data of 1248 patients with a mean age of 69 years were analyzed. The prevalence of at risk and malnutrition was 33.0% (412 of 1248) and 6.9% (87 of 1248), respectively. Overall, 12.4% (155 of 1248) had major postoperative complications, and the MNA‐SF score was a significant predictor (odds ratio: 0.92, 95% CI: 0.86–0.99) after adjusting for confounders. Patients at risk of malnutrition and those with malnutrition had a longer hospital length of postoperative stay than normal patients (P = 0.001); however, there was no statistical significance in unplanned readmission rate between the three groups (P = 0.14). Conclusion Preoperative nutrition disorder was common, and it affected postoperative adverse outcomes. The MNA‐SF score was associated with major postoperative complications.