Effects of preoperative oral carbohydrate on clinical outcomes of patients undergoing hip fracture surgery: a protocol for systematic review and meta-analysis of randomised controlled trials.

Abstract

Hip fractures are a prevalent type of fracture and a leading cause of disability and mortality among older patients, imposing a substantial burden on both families and society. As surgical intervention is considered the primary means of improving patient outcomes, perioperative optimisation management is essential for enhancing prognosis. A key component of the Enhanced Recovery After Surgery (ERAS) protocol for hip surgery is the innovation of preoperative fasting concepts, which includes the recommendation of preoperative oral carbohydrates for surgical procedures, particularly hip surgery. While preoperative oral carbohydrates have been shown to alleviate hunger and thirst symptoms in patients and promote postoperative recovery, concerns regarding intraoperative aspiration and gastric content retention persist, rendering the safety and feasibility of this approach for surgery a topic of debate. This study aims to investigate and summarise the clinical outcomes of preoperative oral carbohydrates in patients undergoing hip surgery, providing a comprehensive evaluation of their impact on patient recovery and safety. A systematic and comprehensive search will be conducted across multiple databases, including CINAHL, PubMed, CNKI, VIP database, Wanfang database, Embase, CBM, Web of Science, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov (https://www. gov/), from their inception to November 2024, to identify randomised controlled trials that examine the effect of preoperative oral carbohydrates on patients with hip fractures. The primary outcome of interest will be postoperative insulin sensitivity. The literature search will be screened independently by two researchers to identify eligible articles for inclusion in this meta-analysis. Subsequent data extraction and assessment of risk of bias will be performed. This meta-analysis will provide a comprehensive summary of the available data for each outcome, provided that sufficient data are available. The presence of heterogeneity among the included studies will be evaluated using the χ² test and the I² statistic, allowing for the quantification of inconsistency across the studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols are adhered to in this systematic review and meta-analysis. This study uses previously published data, and as such, does not require additional ethical approval. The findings will be disseminated through peer-reviewed journals. CRD42024611468.