Yap, Kai Sing and Loh, Pui San and Foong, Yi Xian and Mok, Chu Zhen and Ong, Terence and Khor, Hui Min (2024) A feasibility study on preoperative carbohydrate loading in older patients undergoing hip fracture surgery. BMC Geriatrics, 24 (1). p. 401. ISSN 1471-2318, DOI https://doi.org/10.1186/s12877-024-04958-7.
Full text not available from this repository.Abstract
Background Preoperative carbohydrate loading in Enhanced Recovery After Surgery is an independent predictor of postoperative outcomes. By reducing the impact of surgical stress response, fasting-induced insulin resistance is modulated. As a clear fluid, consuming carbohydrate drink is safe up to 2 h preoperatively. Widely practiced in abdominal surgeries, its implementation in hip fracture surgeries is yet to be recognized. This study aimed to identify the feasibility of preoperative carbohydrate loading in hip fracture surgery and assess its clinical effects.Methods This was a randomized controlled, open labelled trial. Patients >= 65 years old without diabetes mellitus, has hip fracture were recruited in a tertiary hospital between November 2020 and May 2021. The intervention was carbohydrate loading versus standard preoperative fasting.Results Thirty-four ASA I-III patients (carbohydrate loading and control, n = 17 each), mean age 78 years (SEM +/- 1.5), mean body mass index 23.7 (SEM +/- 0.6 kg/m2) were recruited. Analysis for feasibility of carbohydrate loading (n = 17) demonstrated attrition rate of 29% (n = 5). Otherwise, all recruited patients were compliant (100% compliance) with no adverse events reported. There was no significant difference among groups in the postoperative nausea and vomiting, pain score, fatigue level, muscle strength, postoperative infection and length of hospital stay assessed at 24-48 h postoperatively.Conclusion The implementation of preoperative carbohydrate loading was found to be feasible preoperatively in hip fracture surgeries but requires careful coordination among multidisciplinary teams. An adequately powered randomized controlled study is needed to examine the full benefits of preoperative carbohydrate loading in this group of patients.Trial registration This study was registered in ClinicalTrial.gov (ClinicalTrials.gov identifier: NCT04614181, date of registration: 03/11/2020).
| Item Type: | Article |
|---|---|
| Funders: | Nestle SA |
| Uncontrolled Keywords: | Carbohydrate loading; Hip fracture; Elderly |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine > Anaesthesiology Department Faculty of Medicine > Medicine Department Universiti Malaya Medical Centre (UMMC) |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 30 Sep 2024 04:32 |
| Last Modified: | 30 Sep 2024 04:32 |
| URI: | http://eprints.um.edu.my/id/eprint/45249 |
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