The Impact of Malnutrition on Post-Operative Complications in Patients with Ovarian Cancer: A NSQIP Study

We aimed to evaluate the impact of malnutrition on post-operative mortality and complications in patients undergoing surgery for ovarian cancer (OC). In this retrospective cohort study utilizing the ACS NSQIP database (2013-2022), all individuals with a diagnosis of OC were included. Patients were classified as having "malnutrition" if they met any of the following: (1) pre-operative albumin level <3.5 g/dL; (2) ≥10% weight loss over 6 months + BMI = 18.5-20 kg/m² in patients <70 years old or BMI = 18.5-22 kg/m² in patients ≥70 years); and (3) BMI < 18.5. Baseline characteristics, 30-day post-operative mortality and complications were compared between "malnutrition" and "no malnutrition" groups. Of the 20,174 included, 8744 (43.3%) had malnutrition and 11,430 (56.7%) had no malnutrition. The malnutrition group had longer total length of hospital-stay (mean days 4.78 vs. 4.17, p < 0.0001), higher rates of venous thromboembolism, and higher cardiac morbidity compared to "no malnutrition". On univariate analysis, mortality was higher in the "malnutrition" group (0.8% vs. 0.3%, p < 0.0001). This remained significant after adjusting for potential confounders (aOR 2.92, 95% CI 1.92-4.43, p < 0.0001). In conclusion, in patients undergoing surgery for OC, malnutrition increased the risk of post-operative mortality and complications. Malnutrition assessment should be integrated in pre-operative counseling in patients undergoing surgery for OC.