Nutritional screening for risk prediction in patients scheduled for abdominal operations

Abstract

In abdominal surgery, preoperative investigation of feeding habits may be sufficient to identify patients at increased risk of complications. Nutritional risk alone, however, is not sufficient to predict individual risk of complications reliably.

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway

“…50 This recommendation is based on the concept that preoperative nutritional care should be introduced early for malnourished and nonmalnourished patients to maintain optimal nutritional status throughout the entire perioperative period. 50 Further, Kuppinger et al 51 showed that for patients undergoing abdominal surgery, lower food intake before hospital admission was an independent risk factor for postoperative complications. It is possible in patients found to be malnourished as judged by PONS score components, such as >10% weight loss in past 3 months or reduced oral intake (<50%) in past 7 days, that surgery should consider being delayed until a reasonable period of compliance with Table 2.…”

Potentially fatal complications for elderly patients after laparoscopy-assisted distal gastrectomy

“…The reason for this non-inclusion is that operator selection is a potential risk of bias because difficult cases tended to be operated by experts and some of the relatively easy cases are done by trainees, particularly in this cohort. ASA-PS classification is a reported predictive factor of postoperative complications after major abdominal surgeries for colorectal and pancreatic disease [36][37][38]. ASA-PS class 2 defines ''a patient with mild systemic disease'' such as controlled hypertension, diabetes without systemic effects, and cigarette smoking without chronic obstructive pulmonary disease [39].…”

Ernährung bei operativen Maßnahmen

“…Dieses Screeninginstrument ist auch für chirurgische Patienten in aktuellen Studien validiert worden [33]. In einer großen Kohortenstudie hat sich bei abdominalchirurgischen Patienten eine verminderte Nahrungsaufnahme in der Woche vor der Krankenhausaufnahme als ein noch besserer Risikoprädiktor gezeigt [19]. Für älte-re chirurgische Patienten (> 65 Jahre) konnten in einer systematischen Über-sicht von 15 Studien aus den Jahren 1998 bis 2008 nur der Gewichtsverlust und das Serumalbumin als prädiktive Parameter für postoperative Komplikationen gefunden werden [36].…”