Dietary supplement use and clinical recovery after emergency surgery for perforated peptic ulcer: a prospective cohort study

OBJECTIVES: Evidence connecting habitual pre-admission dietary supplement use with recovery after emergency perforated peptic ulcer surgery is limited. This study aimed to assess the association between regular pre-admission dietary supplement use and postoperative day-7 clinical recovery, complications, and hospital stay. METHODS: In this prospective cohort, 120 adults underwent emergency surgery at Ghurki Trust Teaching Hospital, Lahore, from March 2025 to March 2026. Regular use was intake on at least four days weekly for at least four consecutive weeks during the preceding three months. The primary outcome was a clinically assessed composite of satisfactory recovery by postoperative day 7. Associations were estimated using logistic regression adjusted for demographic, nutritional, illness-severity, and operative characteristics. RESULTS: Forty-six participants (38.3 %) were regular supplement users. Day-7 recovery occurred in 34/46 (73.9 %) users and 39/74 (52.7 %) non-users (unadjusted OR 2.54, 95 % CI 1.14-5.66; p=0.021). Postoperative stay was shorter among users (median 6 [IQR 5-8] vs. 8 [6-11] days; p=0.003). The adjusted association with day-7 recovery was OR 2.31 (95 % CI 1.03-5.18; p=0.042). Higher albumin was associated with recovery; presentation after 24 h, hypotension, and diffuse contamination were associated with lower odds. Individual complications and mortality were uncommon and did not differ significantly. CONCLUSIONS: Pre-admission supplement use was associated with better short-term clinical recovery, but the small, observational cohort, potential residual confounding, and a non-validated recovery composite preclude causal interpretation. Larger studies with precise exposure and validated outcome assessment are needed.