Malnutrition risk in elective surgery patients and effectiveness of preoperative nutritional interventions at a pre-anaesthetic clinic: a 4-year apart, single-centre, observational study

Abstract

Background Approximately 44% of all patients hospitalised for an elective surgical procedure have a malnutrition risk. In this study, we assessed the prevalence of malnutrition risk at a pre-anaesthetic clinic and the feasibility of introducing nutritional support. The primary objective of this study was to assess malnutrition risk prevalence in patients referred to a pre-anaesthetic clinic. Methods This was a prospective observational study. The study was divided into two phases: one in 2020 and the other in 2023. Consecutive patients scheduled for an elective surgical procedure at a pre-anaesthetic clinic were asked to participate in the study by filling out the questionnaire. We divided the patients into two groups based on the GLIM criteria. Results We included a total of 467 patients, including 214 from 2020 and 253 from 2023. In the total sample, 93 (19.9%) patients met the GLIM criteria for malnutrition risk, and 37 (7.9 %) fulfilled the ESPEN criteria for preoperative nutritional support. Out of 93 patients at malnutrition risk, 41 (44%) had BMI > 25 kg m –2 . The number of patients with indications for preoperative nutritional support in all departments remained similar across both time points. However, the number of patients receiving preoperative ONS almost doubled over the study period (36.8% in 2020 vs. 72.2% in 2023). Conclusions Malnutrition risk was consistently high among our elective surgery patients. Not all patients with indications for preoperative nutritional support received it. As such, pre-anaesthetic clinics might be one of the major links in the nutritional programme chains of hospitals.

PreScheck Team Study: prehabilitation clinic as an effective patient management tool in elective cardiac surgery

“…It is reported that approximately 44% of all patients hospitalized for an elective surgical procedure are at risk for malnutrition. Preoperative malnutrition is associated with increased risk of postoperative complications, increased mortality and prolonged hospital stay [ 26 ]. Obese patients require a comprehensive assessment of nutritional status, and malnutrition often goes undiagnosed [ 26 ].…”

“…Preoperative malnutrition is associated with increased risk of postoperative complications, increased mortality and prolonged hospital stay [ 26 ]. Obese patients require a comprehensive assessment of nutritional status, and malnutrition often goes undiagnosed [ 26 ].…”

The use of the ERAS protocol in malnourished and properly nourished patients undergoing elective surgery: a questionnaire study

“…Some new parameters are debated as potential laboratory tests in malnutrition screening [ 12 ]. Our previous study concerning the evolution of patients in a pre-anaesthetic clinic revealed a lower prevalence of weight loss among these individuals [ 13 ]. Only 20% of patients (93 of 467) experienced relevant weight loss in the pre-anaesthetic clinic.…”

Nutritional responsiveness affects novel neutrophil parameters and reduces in-hospital mortality and costs in elective cancer oesophagectomy – a single centre, prospective, observational study

“…Unlike other nutritional assessment protocols, GLIM is not a screening tool but a diagnostic one. Almost 20% of elective surgery patients meet the GLIM criteria for malnutrition, and this prevalence rises to 40% in patients scheduled for elective surgery for cancer [ 2 ]. Oesophageal and oesophago-gastric junction cancer is a disease associated with one of the highest malnutrition rates among all surgical cancer patients, reaching up to 80% [ 3 ].…”