Malawi Medical Journal
College of Medicine, University of Malawi and Medical Association of Malawi
Vol. 30, No. 2, 2018, pp. 79-85
Bioline Code: mm18017
Full paper language: English
Document type: Research Article
Document available free of charge
Malawi Medical Journal, Vol. 30, No. 2, 2018, pp. 79-85
© Copyright 2018 - The College of Medicine and the Medical Association of Malawi
An observational study of perioperative nutrition and postoperative outcomes in patients undergoing laparotomy at Queen Elizabeth Central Hospital in Blantyre, Malawi|
Katundu, Kondwani G.H.; Mutafya, Timothy W.; Lozani, Noel C.; Nyirongo, Patrick M. & Uebele, Molly E.
Nutritional status in patients undergoing surgery can influence their immune function, tissue repair and, hence, clinical outcomes. This
study aimed to assess the perioperative nutrition and postoperative outcome of patients undergoing laparotomy at a tertiary hospital
A total of 25 patients were included in this prospective, observational study. The Subjective Global Assessment was used to classify each
patient according to nutritional status. Handgrip strength was measured for each patient preoperatively and at day 3 postoperatively.
Anthropometric measurements were also done. Protein and energy requirements for each participant were estimated and compared to
the quantities provided by the hospital diet. Patients were followed up until discharge and outcome variables which included length of
hospital stay and wound dehiscence or infectious complications were recorded.
Of the study participants, 20% were well-nourished, 52% were moderately malnourished and 28% were severely malnourished. The
median handgrip strength decreased at day 3 postoperatively from the preoperative handgrip strength. Well-nourished patients had
higher handgrip strength than malnourished patients both preoperatively and postoperatively. Total energy and protein provided by the
hospital diet were significantly lower than the estimated requirements for the patients. Severely malnourished patients had increased
median length of hospital stay and increased rate of postoperative complications. Preoperative and postoperative day 3 handgrip
strength correlated negatively with the number of postoperative complications and length of hospital stay.
This study showed high rates of malnutrition and inadequate in-hospital nutritional support which were associated with poor clinical
outcomes, especially in severely malnourished patients. Proper nutritional assessment and provision of adequate nutritional support
should be reinforced in surgical patients to promote favourable clinical outcomes postoperatively. Further studies with larger sample
sizes in other patient populations and hospitals in Malawi are required in this area.
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