PMID- 38098008 OWN - NLM STAT- MEDLINE DCOM- 20231216 LR - 20231217 IS - 1749-799X (Electronic) IS - 1749-799X (Linking) VI - 18 IP - 1 DP - 2023 Dec 14 TI - The association between oral carbohydrate intake before orthopedic surgery for osteoporotic fractures and outcomes in elderly patients. PG - 966 LID - 10.1186/s13018-023-04458-1 [doi] LID - 966 AB - BACKGROUND: Oral carbohydrate (CHO) intake is a safe method with effective clinical results in various surgical patients before surgery. Nevertheless, due to a lack of adequate clinical data, it is not frequently utilized in older patients undergoing orthopedic surgery for osteoporotic fractures (OPFs), especially in China. The purpose of the present study was to examine the relationship between preoperative oral CHO consumption and outcomes in elderly patients undergoing surgical treatment for OPFs. METHODS: This retrospective cohort study was conducted at a single Chinese institution and included a total of 879 elderly patients (median age: 71 years; range: 50-99 years) who underwent OPF surgery. Various exclusion criteria were established as follows: (a) the necessity for urgent surgical intervention; (b) the existence of hypoglycemia, hyperglycemia, or diabetes mellitus with blood glucose levels lower than 2.8 mmol/L; (c) a medical history of gastrointestinal motility disorders or delayed gastric emptying; (d) the utilization of local anesthesia; (e) a Charlson comorbidity index (CCI) score over 2; and (f) an American Society of Anesthesiologists (ASA) score exceeding 3. After propensity score (PS) matching, 264 patients from each cohort were included in the analysis. The primary outcome was the all-cause mortality rate within 60 days post-surgery, while secondary outcomes included the length of hospital stay (LOS), hospitalization costs, intraoperative and postoperative blood transfusions, and the incidence of postoperative nausea and vomiting (PONV) and aspiration. The relationship between preoperative oral CHO intake and outcomes was evaluated using multivariate regression analysis. RESULTS: After PS matching, preoperative oral CHO intake was negatively associated with 60-day mortality in the fully adjusted model (odds ratio 0.35; 95% confidence interval 0.12-0.97; P-value: 0.04). Patients who received preoperative oral CHO intake also had a shorter LOS and lower hospitalization costs than those who did not receive CHO intake. However, none of the models showed a significant association between CHO intake and PONV or blood transfusion risk. Furthermore, no cases of aspiration were observed in either cohort. CONCLUSIONS: Preoperative oral CHO intake may be associated with reduced mortality risk and improved outcomes in elderly patients undergoing surgical treatment for OPFs. However, it is important to acknowledge the limitations of our study, including its retrospective nature, potential unmeasured confounding variables, the small sample size, incomplete data on important variables such as duration of surgery and inflammatory markers, and the limited generalizability due to the participation of only one institution. Future research with larger sample sizes and a broader range of events is warranted to validate and enhance the validity of our findings, particularly in assessing long-term results and understanding the underlying mechanisms. CI - (c) 2023. The Author(s). FAU - Zhu, Jing AU - Zhu J AUID- ORCID: 0000-0002-1915-0928 AD - Department of Nursing, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China. FAU - Jin, Xue-Qin AU - Jin XQ AUID- ORCID: 0000-0002-0792-7146 AD - Department of Nursing, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China. FAU - Li, Xiao-Yan AU - Li XY AD - Department of Nursing, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China. FAU - Sun, Li AU - Sun L AD - Department of Nursing, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China. FAU - Peng, Yuan AU - Peng Y AUID- ORCID: 0000-0001-8789-7399 AD - Intensive Care Unit, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, Jiangsu, China. py9746@163.com. LA - eng GR - KS2211/Kunshan Key Research and Development Program Project/ GR - 2022M711439/China Postdoctoral Science Foundation/ GR - LKZ2022020/Elderly Health Research Project of Jiangsu Province/ PT - Journal Article DEP - 20231214 PL - England TA - J Orthop Surg Res JT - Journal of orthopaedic surgery and research JID - 101265112 RN - 0 (Carbohydrates) SB - IM MH - Humans MH - Aged MH - Retrospective Studies MH - Postoperative Nausea and Vomiting MH - *Osteoporotic Fractures MH - *Orthopedic Procedures MH - Carbohydrates MH - Postoperative Complications/epidemiology PMC - PMC10722799 OTO - NOTNLM OT - Carbohydrate OT - Elderly patients OT - Hospitalization cost OT - Length of hospital stay OT - Mortality OT - Osteoporotic fracture COIS- The authors declare that they have no competing interests. EDAT- 2023/12/15 06:42 MHDA- 2023/12/17 17:41 PMCR- 2023/12/14 CRDT- 2023/12/15 00:18 PHST- 2023/08/19 00:00 [received] PHST- 2023/12/10 00:00 [accepted] PHST- 2023/12/17 17:41 [medline] PHST- 2023/12/15 06:42 [pubmed] PHST- 2023/12/15 00:18 [entrez] PHST- 2023/12/14 00:00 [pmc-release] AID - 10.1186/s13018-023-04458-1 [pii] AID - 4458 [pii] AID - 10.1186/s13018-023-04458-1 [doi] PST - epublish SO - J Orthop Surg Res. 2023 Dec 14;18(1):966. doi: 10.1186/s13018-023-04458-1.