Association of preoperative nutritional status with early postoperative complications following Loop Ileostomy Closure surgery in a Bangladeshi tertiary care hospital

Abstract

Objective Preoperative nutritional status is an important predictor of postoperative outcome in surgery. The aim was to investigate the association of preoperative nutritional status with short-term (up to 30 days) postoperative outcomes among Bangladeshi patients undergoing loop ileostomy closure (LIC). Methods A prospective observational study was conducted on 60 subjects [Median age 45 years; Males, 70%] undergoing LIC in a tertiary care public sector hospital after 8-24 weeks of Loop Ileostomy Surgery. Nutritional status was assessed by the Malnutrition Universal Screening Tool (MUST) as well as by Body Mass Index (BMI, Asian population criteria). Major systemic and surgery-related complications, along with Clavien-Dindo severity gradation, were the primary outcome variables. Results More than half (56.7%) of subjects suffered from undernutrition, of whom 21.7% had severe undernutrition (BMI <16.0). Using MUST, 56.7% showed a high undernutrition risk and 11.7% had moderate risk. As per Clavien-Dindo postoperative complication grading, 36.7% had no complications, 25% had Grade II complications, and 16.7% had Grade III complications. Mean BMI was significantly lower among patients with Grade II complications than among those without complications (16.77 ± 2.79 vs 19.39 ± 3.40 kg/m²; p=0.019). No MUST-Tool-based Undernutrition Risk Group showed any significant association with any of the Clavien-Dindo Complication Groups. Conclusions More than half of patients undergoing LIC in a tertiary public hospital in Bangladesh are underweight (with around one-fifth being severely underweight). Lower preoperative BMI is independently associated with postoperative complications in LIC surgery and may help identify patients requiring closer nutritional assessment. Bangladesh Journal of Medical Science Vol. 25 No. 04 October’26 Page: 1274-1281