Impact of Malnutrition on Postoperative outcomes in Elective Surgeries at Lady Reading Hospital Peshawar

Abstract

Background: Nutritional status is a critical determinant of surgical outcomes. Malnutrition, including undernutrition and over nutrition, can affect intra-operative hemodynamics, postoperative recovery, and hospital stay. This study aimed to assess the impact of preoperative nutritional status on postoperative complications, emergence from anesthesia, and length of hospital stay in patients undergoing elective surgery.

Methods: A descriptive cross-sectional study was conducted at Lady Reading Hospital, Peshawar, from September to November 2025. A total of 123 adult patients (aged 18–60 years, ASA I or II) undergoing elective surgery were enrolled using non-probability convenience sampling. Preoperative nutritional status was assessed using body mass index (BMI) according to WHO classification. Standardized general anesthesia was administered, and intra-operative hemodynamics, postoperative complications, and length of hospital stay were recorded. Data were analyzed using SPSS with descriptive statistics, Chi-square test, and one-way ANOVA; p < 0.05 was considered statistically significant.

Results: Of the 123 participants, 48 (39%) were male and 75 (61%) female, with a mean age of 38.48 ± 12.60 years. The mean BMI was 26.65 ± 4.79 kg/m², with 32.9% in the normal range and 67.1% classified as malnourished (pre-obese 37.4%, obese class I 22.4%). Postoperative recovery was smooth in 95.1% of patients; delayed emergence occurred in 4.9%, while nausea, vomiting, and respiratory complications were infrequent. Most patients (98.8%) were discharged within 24–48 hours. BMI categories were not significantly associated with postoperative complications, except for mean arterial pressure after induction of anesthesia, which showed a significant association (F = 2.78, p = 0.008).

Conclusion: A majority of patients undergoing elective surgery were malnourished, primarily overweight or obese. Poor nutritional status was not significantly associated with postoperative complications or length of hospital stay, but higher BMI influenced intra-operative hemodynamic stability. Preoperative assessment of nutritional status should be incorporated into routine surgical evaluation to optimize peri-operative care. Future studies with larger sample sizes are recommended to further explore the impact of nutritional status on surgical outcomes.