Association between preoperative malnutrition and hospital length of stay in adults with major lung resection: A prospective cohort study: GI Signals

Nutrition prospective cohort · n=62 · Aug 23, 2026 · JPEN · IF 3.2

Association between preoperative malnutrition and hospital length of stay in adults with major lung resection: A prospective cohort study.

Epidemiologymalnutritionhealth servicesepidemiology

Clinical takeawayScreen for preoperative malnutrition in patients scheduled for lung resection to identify those at high risk for prolonged hospitalization and infection. Consider referral for nutritional assessment and targeted interventions; however, evidence that intervention improves postoperative outcomes is not yet established.

What it foundPreoperative malnutrition associated with longer hospital stay (7 vs 4.5 days median) and higher postoperative infection risk (OR 7.0, 95% CI 1.3-36.2) in a prospective cohort of 62 lung resection patients.

ContextMalnutrition is recognized as a risk factor for poor surgical outcomes generally. This prospective study confirms associations in lung resection, though with important population specificity. The unadjusted LOS difference (7 vs 4.5 days) was observed overall; the adjusted analysis (β = 4.2 days) applies specifically to patients undergoing resection for infectious disease, suggesting the strength of benefit may be population-dependent. The postoperative infection risk (OR 7.0) had a wide confidence interval (95% CI 1.3-36.2), limiting the precision of this estimate. Notably, objective measures of nutritional status-fat-free mass index and handgrip strength-did not significantly differ between malnourished and normally nourished groups, suggesting the 7-point SGA may capture clinically relevant nutritional factors not apparent on standard anthropometric assessment.

Emergingsuggested applicable standard· American Gastroenterological Association, 'AGA Clinical Practice Update on Surgical Risk Assessment and Perioperative Management in Cirrhosis: Expert Review' (Northup PG et al., Clin Gastroenterol Hepatol 2019;17(4):595-606). DOI 10.1016/j.cgh.2018.09.043, PMID 30273751.

Decision at stakeidentify and optimize modifiable risk factors before clearing elective major surgery

… Defer elective surgery for active GI bleeding, active IBD flare, recent pancreatitis, or unoptimized anemia, and specify perioperative precautions (stress-dose steroids, biologic hold matrix, GLP-1/SGLT2 holds, aspiration precautions) where indicated.

From our summary of this standard, unedited — the part the paper bears on. … marks omitted text. Our wording, not the guideline's; read the source for its own text.

Our full summary of this standard

Determine GI surgical clearance based on the specific condition and its activity rather than an automatic sign-off: most stable chronic GI conditions (GERD, IBS, controlled IBD, compensated MASLD, asymptomatic gallstones) may be cleared, while active conditions, cirrhosis, and perioperative drug management require explicit stratification and documentation. For any cirrhotic patient, perform mandatory risk stratification with VOCAL-Penn and Child-Pugh class before clearance; manage variceal prophylaxis per individualized endoscopic and hemodynamic assessment (including NSBB for appropriate candidates) and address rebalanced hemostasis without prophylactic INR correction. Defer elective surgery for active GI bleeding, active IBD flare, recent pancreatitis, or unoptimized anemia, and specify perioperative precautions (stress-dose steroids, biologic hold matrix, GLP-1/SGLT2 holds, aspiration precautions) where indicated.

American Gastroenterological Association, 'AGA Clinical Practice Update on Surgical Risk Assessment and Perioperative Management in Cirrhosis: Expert Review' (Northup PG et al., Clin Gastroenterol Hepatol 2019;17(4):595-606). DOI 10.1016/j.cgh.2018.09.043, PMID 30273751. · reviewed 2026-07-21 ↗

Lamoyi-Domínguez PR … Osuna-Padilla IA · JPEN. Journal of Parenteral and Enteral Nutrition · IF 3.2 · PubMed ↗Permalink