Nutritional health is crucial for recovery and outcomes following major elective surgery, with malnutrition linked to an increased risk of complications, longer hospital stays, and slower recovery. Pre-admission nutritional interventions, including meal counseling and supplements, increase patient resiliency and improve surgical outcomes. This systematic review sought to evaluate the effectiveness of such therapies, giving significant insights for improving preoperative care and modifying clinical guidelines. This study used four data-bases by the Cochrane Handbook and preferred reporting items for systematic reviews and meta-analyses recommendations. Two writers independently screened and chose randomized controlled trials (RCTs). The study looked at outcomes such as Length of stay (LOS), surgical complications, and mortality. Bias was calculated using the Cochrane Risk of bias revised tool (ROB2), and Revman was used to conduct the meta-analysis. The risk ratios (RRs) and pooled mean differences were employed to evaluate outcomes, with significance set at p < 0.05. The search approach initially identified 803 studies, with seven RCTs included in the final review. The meta-analysis found no statistically significant effects on critical outcomes such as LOS, postoperative complications, or mortality. Although there was a trend toward shorter LOS (pooled mean difference of -0.54 days, 95% CI: -1.37 to 0.29, p-value = 0.20) and a 16% reduction in postoperative complications (RR 0.84, 95% CI: 0.62 to 1.15, p-value = 0.28), neither outcome was statistically significant. Similarly, there was no significant difference in mortality between the intervention and control groups (RR 1.18, 95% CI: 0.23-6.11, p-value = 0.85). The meta-analysis revealed no statistically significant impact of pre-admission dietary treatments on LOS, complications, or mortality. Thus, future research should focus on improving intervention methods, identifying patient subgroups that might benefit the most, and integrating various components of perioperative care.
Key words: Pre-admission nutritional interventions, oral dietary supplements, length of hospital stay, mortality, postoperative complications
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