Perioperative nutrition is still a surgical orphan: results of a Swiss–Austrian survey

Grass, Fabian; Cerantola, Yannick; Schäfer, Markus; Müller, Sven; Demartines, Nicolas

doi:10.1038/ejcn.2011.13

Cited by 38 publications

(33 citation statements)

References 16 publications

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“…In reality, about 30% of hospitals rarely or never assess patients' nutritional status preoperatively as recently published by our group [4]. Our findings are in accordance with a recent European survey showing that only 52% of the interrogated units reported a screening routine [14].…”

Section: Discussionsupporting

confidence: 94%

“…In general, preoperative nutritional assessment of surgical patients is performed either by surgeons, nurses, or by nutrition specialists [4]. However, there is little information available, whether the application of the NRS is really easy and reproducible in daily clinical practice, and how important the inter-observer variability is between surgeons and nutrition specialists.…”

Section: Introductionmentioning

confidence: 99%

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Use of the nutritional risk score by surgeons and nutritionists

et al. 2016

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Use of the nutritional risk score by surgeons and nutritionists

et al. 2016

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“…30,33,34 Modern nutritional formulas entail however 'pharmacological' effects beyond the mere improvement of patients' nutritional status. 35,36 A distinct attribute of immuneenhancing agents is a modulation of the humoral and cellular immune function, that is, a reduction of SIRS and postoperative infection rates.…”

Section: Discussionmentioning

confidence: 99%

Preoperative immunonutrition in patients at nutritional risk: results of a double-blinded randomized clinical trial

et al. 2012

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BACKGROUND/OBJECTIVES:To evaluate the impact of preoperative immunonutrition (IN) on postoperative morbidity in patients at risk of malnutrition undergoing major gastrointestinal (GI) surgery. SUBJECTS/METHODS: The combination of malnutrition and major GI surgery entails high morbidity. The Nutritional Risk Score (NRS) reliably identifies patients who need preoperative nutrition; the optimal nutritional formula for these patients still needs to be defined. In all, 152 patients with a NRSX3 and undergoing elective major GI surgery were randomized between IN or isocaloricisonitrogenous nutrition (ICN) given for 5 days preoperatively. Patients and caregivers were blinded for the allocated intervention. Thirty days complication rate was the primary endpoint. Infections, length of hospital stay and compliance were considered as secondary outcomes. RESULTS: Overall, 145 patients were available for analysis; the 73 patients in the IN group matched well with the 72 ICN patients with regards to patient's and surgical characteristics. In all, 39 IN and 33 ICN patients experienced a total of 48 and 50 postoperative complications, respectively (P ¼ 0.723). Both groups did not differ significantly concerning infectious (13 vs 9) complications. Independent risk factors for overall complications were malignant disease (odds ratio (OR) ¼ 4.304; confidence interval (CI) 1.317-14.002) and operative time (OR ¼ 1.004; CI 1.000-1.008). CONCLUSION: In patients at nutritional risk, complications, infections and hospital stay after major GI surgery were comparable regardless of preoperative supplementation with IN or ICN.

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“…Two of the three studies on the subject demonstrated that the surgical trainees had an insufficient level of knowledge regarding clinical nutrition (6, 7). Another study, which is the only large-scale study on the current practice of general surgeons with regard to clinical nutrition, surveyed the chairmen of the surgery clinics in Switzerland and Austria regarding the current clinical practice at their centers and demonstrated insufficient implementation of nutrition guidelines (5). The aim of the present study was to screen a broad population of general surgeons in Turkey for the awareness of nutritional principles and their clinical practices, as well as to discuss the influence of some potential factors that may affect their tendencies.…”

Section: Discussionmentioning

confidence: 99%

Surgeons’ approach toward clinical nutrition: A survey-based study

et al. 2017

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Surgeons' approach toward clinical nutrition: A survey-based study INTRODUCTIONIt is a well-known fact that surgical patients with a suboptimal nutritional status have impaired wound healing, impaired immune responses, increased organ dysfunction, delayed recovery, and increased morbidity and mortality (1, 2). However, even though the prevalence of malnutrition is high and may exceed 60% in patients undergoing gastrointestinal or major elective surgeries, many cases of malnutrition probably go unnoticed and untreated in surgical wards (3-6). As the attending specialist, the surgeon must organize nutritional screening and treatment of the patients in a surgical clinic. This necessitates surgeons to have sufficient knowledge of nutrition and to be very sensitive about the nutritional status of their patients. Unfortunately, limited data on the degree of attention paid to this important subject by surgeons suggests that the awareness of nutritional principles may be insufficient among this group of clinicians (5-7). This study displays the results of a survey designed to define the current attitudes of Turkish surgeons toward nutritional screening and support. MATERIAL AND METHODSA questionnaire consisting of 13 multiple choice questions was designed by the study authors to investigate the surgeons' approaches to perioperative nutritional screening and therapy of the general surgery patient (Appendix). This survey was e-mailed to 1500 general surgeons, all of whom had already finished the training program in surgery and were working in different hospitals in the Turkish Republic. A cover letter that stood for an informed consent was also attached to this e-mail explaining the purpose of this project and assuring the participants of anonymity.Since this study was based on a survey answered by doctors, no approval was obtained from any ethics committees; however, the study was conducted according to the Helsinki Declaration.Only the surgeons who stated that they screened the nutritional status of their patients were asked to answer the questions from 5 to 11 as it was essential to take part in nutritional screening in daily clinical practice to answer these questions.The answers of each surgeon were stored in a database and cross-queries were made over these responses. The surgeons who were working in state hospitals were compared with the surgeons working in teaching Objective: Although many surgical patients face postoperative problems due to a poor nutritional status, there is evidence that many cases of malnutrition still go unnoticed and untreated in surgical wards. This study aims to define the current attitudes of surgeons toward nutritional screening and support. Material and Methods:A questionnaire with 13 questions was e-mailed to 1500 surgeons. Cross-queries were made over the responses. Results:The response rate was 20.9%. Most of the respondents (89.5%) implemented nutritional screening. However, only 24.6% of these surgeons screened every patient for malnutrition. The time to initiate nutritional suppor...

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Perioperative nutrition is still a surgical orphan: results of a Swiss–Austrian survey

Cited by 38 publications

References 16 publications

Use of the nutritional risk score by surgeons and nutritionists

Use of the nutritional risk score by surgeons and nutritionists

Preoperative immunonutrition in patients at nutritional risk: results of a double-blinded randomized clinical trial

Surgeons’ approach toward clinical nutrition: A survey-based study

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