People who have multiple orthopedic surgeries during the same hospital stay are more likely to suffer malnutrition due to repeated or prolonged fasting, which can slow recovery and increase the risk of death, according to a study of more than 28 million patients presented at the ANESTHESIOLOGY ® 2024 annual meeting. Because food or liquid retained in the stomach increases the risk of regurgitation and aspiration in the airway and lungs during general anesthesia and deep sedation, most patients are directed to fast for at least eight hours before surgery. This is generally accomplished by not eating after midnight.
It is also recommended that only clear liquids may be consumed up to two hours before the procedure. Patients having multiple surgeries while in the hospital, especially those clustered together over several days, are required to fast repeatedly or for cumulative prolonged periods. Our research determined that repeated fasting in hospitalized patients having multiple orthopedic surgeries over days or weeks increases the risk for protein-calorie malnutrition, leading to longer hospital stays, slower recovery and higher health care costs.
While fasting is a crucial part of ensuring patients' safety during surgery, our findings suggest modifications to clinical practice should be considered for patients who are at risk for malnourishment, such as those who are older than 65, have a chronic illness like diabetes or congestive heart failure or have limited access to ade.