Implications of Malnutrition in the Surgical Patient

The Effect of Malnutrition on Patients Undergoing Elective Joint Arthroplasty

“…There is direct support for the use of serum albumin and transferrin in screening for malnutrition and this combination was adopted for this study [4,13]. A threshold value of 3.5 mg/dl was used for serum albumin and 200 mg/dl for serum transferrin [5,13,23,34].…”

“…Gherini et al have shown that both low albumin and transferrin levels are independently associated with increased rates of some postoperative complications [4,8,13]. Furthermore, defining malnutrition as either low albumin or low transferrin allowed an increased sensitivity to identify malnourished patients, possibly at the expensive of some specificity.…”

“…The association between malnutrition and adverse outcomes following major surgical procedures has been documented for over 50 years [1][2][3][4]. In the orthopedic literature there are multiple studies demonstrating poor outcomes in malnourished patients undergoing elective joint arthroplasty, hip fractures and amputations [5][6][7][8][9][10].…”

Clinical Significance of Preoperative Nutritional Status in Pediatric Surgical Patients

“…[1][2][3][4][5][6] Malnutrition in surgical patients has been shown to increase postoperative morbidity and mortality. [7][8][9] A variety of biochemical, anthropometric, and immunologic measurements have been used as indicators of protein-calorie malnutrition and as a predictor of postoperative morbidity and mortality. 7,10,11 The value of preoperative nutritional assessment in predicting postoperative morbidity and mortality is controversial.…”

An Overview of Orthotopic Liver Transplantation

“…19 There are few studies available on the postoperative nutritional needs of liver transplant recipients specifically but it appears that aggressive nutritional support in these patients is as important as it is in other postoperative settings. O'Keefe and colleagues at Cambridge documented daily nitrogen losses equivalent to 90 to 100 g of protein from the fourth postoperative day forward in patients who receive only dextrose after transplant.…”