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Preoperative Nil Per Os Duration Predicts Mortality and Ambulation Following Below-Knee Amputation
Natalie T Chao1, Allison S Karwoski1, Luke T Pitsenbarger1
1University of Maryland School of Medicine, Baltimore, MD, USA.
The American Surgeon
|April 1, 2024
Summary
Prolonged nil per os (NPO) status before surgery is linked to worse outcomes, including increased stroke risk and reduced survival. Shorter NPO duration improves follow-up, ambulation, and mortality rates in below-knee amputation patients.
Area of Science:
- Surgical Outcomes Research
- Patient Recovery Optimization
- Clinical Practice Guidelines
Background:
- Routine nil per os (NPO) orders pre-procedure can cause dehydration and malnutrition.
- The impact of NPO duration on postoperative outcomes requires further investigation.
Purpose of the Study:
- To analyze the association between nil per os (NPO) duration and postoperative outcomes in patients undergoing elective below-knee amputation (BKA).
Main Methods:
- Retrospective chart review of 92 patients undergoing elective BKA (2014-2022).
- Statistical analysis included Chi-square, t-tests, and regression analysis (P < .05 significance).
Main Results:
- Longer NPO duration correlated with higher postoperative stroke rates (P = .03).
- Shorter NPO duration predicted improved 1-year follow-up (OR: 2.9), ambulation (OR: 2.7), and decreased mortality (OR: 0.11).
- No significant impact on postoperative renal function was observed.
Conclusions:
- Prolonged nil per os (NPO) duration is associated with adverse postoperative outcomes, including stroke, and predicts poorer follow-up, ambulation, and survival.
- NPO duration does not appear to negatively affect postoperative renal function.
