Incidence

The incidence of surgical malnutrition may be as little as 5% in those presenting for elective procedures. A greater proportion of emergency cases can result in clinically-defined malnutrition affecting 30-50% of patients.

Preoperative malnutrition did not necessarily predict complications; the underlying disease and types of operative intervention seem to be more important in this respect(1). However, amongst the group that does develop surgical complications, preoperative malnutrition was more common.

It has been stated that preoperatively, those with a weight loss of around 10-15% should be considered for nutritional support.

Notes:

• total parenteral nutrition (TPN), or the complete absence of enteral nutrients, is commonly used in a clinical setting
  • however, a major consequence of TPN administration is the development of mucosal atrophy and a loss of epithelial barrier function (EBF); and this loss may lead to an increase in clinical infections and septicemia

Reference:

• Buzby, G.P. & the Veterans Affairs Total Parenteral Nutrition Cooperative Study Group.Perioperative total parenteral nutrition in surgical patients. NEJM 1991;325: 525-532.
• Yang H, Feng Y, Sun X, Teitelbaum DH. Enteral versus parenteral nutrition: effect on intestinal barrier function. Ann N Y Acad Sci. 2009;1165:338-346.