Journal of Nutrition and Food Security

en Long-term NPO Is a Severe Concern for the Development of Malnutrition in Hospitalized Patients: A Prospective Observational Study public specific orginal article <div style="text-align: justify;">Background: Before elective procedures, patients should be fasted to reduce the risk of pulmonary aspiration due to anesthesia. However, the fasting protocol is sometimes not implemented correctly, and patients are nil per oral (NPO) for an inappropriately long time. For this reason, the authors investigated the NPO duration of hospitalized patients before elective procedures and its relationship with nutritional status, patient outcomes, and 28-day mortality. Methods: A prospective observational cohort study was conducted on hospitalized patients who had experienced fasting before elective procedures. Data on demographics, anthropometric index, Mid-upper arm circumference, NRS-2002 questionnaire, length of hospital stay, and 28-day mortality rate were collected. Pearson correlation coefficient test, receiver operating characteristic (ROC) curves, and Kaplan-Meier analysis were also used. Results: Among 1135 hospitalized patients in different wards, 251 were included. The mean duration of fasting before elective procedures was 31.76±33.02 hours (mostly before elective surgeries). During the NPO period, patients lost 2769.20±2960.24 Kcal and 116.65±124.01 g protein. Moreover, about 41.9% of patients stayed in the hospital for more than 30 days, and 21.1% of patients died in less than 28 days; most of them suffered from malnutrition. Longer NPO duration was related to the rate of 28-day mortality in malnourished hospitalized patients. Conclusions: The results of this study indicated that patients experienced long-term NPO duration before elective procedures, and they lost daily calories and protein requirements, which led to worsening hospital malnutrition and increased length of stay (LOS), ventilator connection, and 28-day mortality. </div> NPO, Fasting, Anesthesia, Malnutrition, Hospitalized patients 651 661 http://jnfs.ssu.ac.ir/browse.php?a_code=A-10-1551-1&slc_lang=en&sid=1 Masoumeh Khalighi Sikaroudi 0000-0002-1829-4591 No Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran Kimia Torabinasab 0000-0003-2556-7751 No Student Research Committee, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sahar Khoshro No Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran Mahdi Hejazi 0009-0005-7248-5195 No Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Seyedeh Farnaz Mirhosseini No Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Farzad Shidfar Farzadshidfar@yahoo.com 0000-0002-6531-9253 Yes Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran Afsaneh Dehnad 0000-0001-5731-8894 No Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran