Food and nutrition insecurity in the perioperative period of surgical oncology patients

Abstract

Evidence has reinforced the idea that shortening perioperative fasting reduces avoidable complications and discomfort. However, the reality of prolonged fasting persists and compromises the food and nutritional safety of surgical patients in Brazilian hospitals. The present study aimed to investigate the characteristics of food and water fasting in cancer patients in the perioperative period. Sixty patients admitted for elective surgeries in the treatment of cancers of the gastrointestinal tract participated. At the bedside, a questionnaire was applied and complemented by records from the operating room and medical records. During fasting, approximately 1 hour before and 4 hours after surgery, patients reported their last and first meal as well as water intake, food complications, hunger, and thirst. A descriptive and inferential statistical analysis was conducted. There was a wide variation concerning duration with a median of 17 hours (min. 5hr – max. 330hr) of preoperative food fasting and 14.1 hours (min. 2.25hr – max. 417hr) of water fasting. Postoperatively, the median time of food and water fasting was 19.2 hours (min. 2.42hr – max. 200hr) and 21 hours (min. 2.5hr – max. 201hr), respectively. Food and water fasting was excessively prolonged, and their application did not take into consideration determinant characteristics of nutritional risk such as age, pre- and post-fasting dietary offer, food complications, and discomfort due to hunger and thirst.

Keywords

• perioperative care. patient safety. food and nutrition security. surgical oncology.