Nutrition

NHS Lothian Prehabilitation

Key Points:

  1. Malnutrition increases the risk of perioperative complications by a factor of 3-4.
  2. Patients potentially at risk of malnutrition should be screened using the Nutritional Risk Screening (NRS) tool.
  3. Patients deemed 'At Risk' using the NRS tool should be referred to a dietician early for decision-making surrounding preoperative nutritional supplementation.

Malnutrition

Undernourishment and malnutrition are long established surgical risk factors. Affected patients lack the reserves to meet the physiological demands of the surgical stress response.

Identifying and addressing malnutrition preoperatively can be challenging, the surgical condition itself may be a contributing or causal factor.

Relatively few patients (1-5%) present for surgery underweight compared to other risk factors. However, the magnitude of perioperative risk increase is 3-4 times and it is therefore crucial to identify early.

Malnutrition Screening

Screening for preoperative malnutrition can be undertaken using the Nutritional Risk Screening (NRS) 2002 tool.

Patients identified as 'At Risk' should be referred to a dietician for decision-making surrounding preoperative nutritional supplementation.

Optimal management is through a multidisciplinary approach and is most effective when implemented early.