Bridging the Gap: The Impact of Preoperative Nutritional Status and Inflammation in Postoperative Pain in Elderly Patients.

Abstract

Nutritional screening is gaining recognition in perioperative medicine, as anesthesiologists need to assess patients' nutritional status to identify malnutrition risks. Poor nutritional status is associated with increased perioperative complications, including postoperative pain. Effective pain management is crucial to prevent acute pain from developing into chronic pain. However, the link between malnutrition and pain is not well established, prompting interest in whether nutritional assessment tools correlate with pain severity. The Mini Nutritional Assessment Short-Form (MNA-SF) is a validated screening tool for geriatric patients, recommended by European Society for Clinical Nutrition and Metabolism (ESPEN) for routine use. The modified Nutrition Risk in Critically Ill (mNUTRIC) score evaluates critically ill patients' nutritional risk, guiding interventions to improve outcomes. This study aimed to explore the relationship between nutritional status, inflammatory markers, and postoperative pain in elderly surgical patients to optimize care. A prospective study involving 108 elderly patients (≥ 70 years) assessed the preoperative nutritional status using MNA-SF, mNUTRIC, Acute Physiology and Chronic Health Evaluation (APACHE), Sequential Organ Failure Assessment (SOFA), and inflammatory biomarkers (C-reactive protein (CRP) and albumin (Alb)). Postoperative pain was measured at surgery, 30 days, and 6 months. Statistical analysis found significant links between the nutritional status and pain outcomes. Higher mNUTRIC and APACHE scores correlated with increased pain, while higher Alb and MNA-SF scores were associated with lower pain levels. Chronic pain at 6 months was strongly linked to poor preoperative nutritional and inflammatory status. Findings suggest that nutritional deficiencies and inflammation are associated with postoperative pain and recovery. Integrating nutritional screening into preoperative assessments could improve outcomes by guiding interventions. Future research should refine predictive models to better understand the complex interplay between nutrition, inflammation, and pain in perioperative care. Trial Registration: ClinicalTrials.gov identifier: NCT06802575.