Introduction Peripheral oedema is frequently observed in critically ill patients following surgery and is commonly attributed to poor nutritional status and associated with worse outcomes. This study assesses the prevalence of generalised oedema following emergency abdominal surgery and the value of early post-operative oedema measurement in predicting clinical outcome.
Methods A prospective cohort study of patients undergoing emergency abdominal surgery at a university surgical unit over a 2-month period was undertaken. Nutritional status data were collected and oedema measured in the early post-operative period. Clinical outcome data were collected until discharge and at subsequent outpatient consultations.
Results 55 patients were included, median age 66. Post-operative complications included ileus (n=9), sepsis (n=6) and death (n=10). Post-operative oedema was present in 19 patients (35%) and associated with prolonged peri-operative fasting (4 vs 1 days, p=0.009) but not BMI (24 vs 27 kg/m2, p=0.16) or pre-admission weight loss (5% vs 3%, p=0.9). Oedema was associated with prolonged hospitalisation (24 vs 10 days, p=0.0004), complications and/or death (68% vs 31%, p=0.007) and a trend towards increased artificial nutritional support (42% vs 22%, p=0.07). Presence of oedema independently predicted death (p=0.016), median follow-up 155.5 days.
Conclusion Generalised oedema is common after emergency abdominal surgery but not predicted by commonly used markers of nutritional status such as BMI or recent weight loss in. Increased peri-operative fasting and subsequent intravenous fluid administration may be a significant contributor to post-operative oedema. Measurement of post-operative oedema may offer utility in identifying those at risk of poor clinical outcome or those requiring artificial nutritional support.
Competing interests None declared.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.