Waseem T, Abbas T.
Assessment of Malnutrition in Surgical patients.
Pak J Surg Jan ;18(2):31-9.

Background: Impaired nutritional status has been frequently reported in surveys estimating protein-energy under nutrition and its serious implications on health, recovery from illness or surgery and hospital costs, but due to certain factors usually an acceptable emphasis has not been laid on the patient`s general nutritional state which results in bad outcome in many ways. There is no routine assessment done to determine patient`s nutritional status at the time of admission and at discharge, which increases the morbidity and mortality both. There is no international consensus on the assessment parameters and significant role of protein energy malnutrition affecting the disease course and postoperative healing in many ways. In a European review of 200 under-nourished patients, only 96 had any nutritional information documented. Another survey by Campbell SE, it has been suggests that malnutrition in hospitalized patients is being underestimated. Objective: To study the dynamics and reasons of wt loss in surgical patients and subsequent correction of those factors with reference to currently advised medical practices. Place and duration of study: This study was conducted in Department of Surgery, Unit II, Jinnah Hospital, Lahore, Pakistan from June 2000 to February 2001. Hospital stay: Patients had stay ranging from 3 days to 60 days depending upon nature of the disease and subsequent surgical management. Simple surgical cases (like appendectomy and cholecystectomy) had an average stay from 3 days to 8 days. Gut resection surgeries ranged from 8 to 20 days and those who developed complications (like fecal fistula) even stayed for 60 days. Conclusions: Surgical patients have malnutrition in surgical ward due to unnecessary preoperative / postoperative starvation, improper control of infections, lack of proper nutritional support, improper surgical al anesthetic technique, disease process itself, financial and healthcare system limitations, and non-consideration of minimal invasive techniques. By modifying these factors to currently advised medical practices, significant weight (wt.) loss in surgical patients can be controlled.

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