Optimizing Nutrition Prior to Surgery

Nutritional status is a major determinant of outcomes for any type of surgery, especially for high-risk patients. Strong for Surgery is an initiative aimed at identifying and improving evidence-based practices to help patients have better surgical outcomes.

The Strong for Surgery nutrition initiative focuses on nutrition screening of patients prior to an operation to determine those at greatest risk for malnutrition. Good nutritional status is important to help patients heal better and fight infection.

The Strong for Surgery Nutrition Checklist addresses three separate components:

• Screening for Malnutrition
• Lab Tests for Risk Stratification
• Screening for Use of Supplements

Resources

Nutrition Checklist

Lab Screening: Serum Albumin Fact Sheet

Use of Nutrition in Risk Stratification

Immunonutrition Studies Compendium

References

1. Hennessey DB, Burke JP, Ni-Dhonochu T, et al. Preoperative hypoalbuminemia is an independent risk factor for the development of surgical site infection following gastrointestinal surgery: a multi-institutional study. Ann Surg. 2010; 252:325-329.
2. Gibbs J, Cull W, Henderson W, et al. National VA Surgical Risk Study. Arch Surg. 1999;134:36–42
3. Banh L. Serum protein as markers of nutrition. What are we treating? Practical Gastroenterology. Oct 2006; 43:46-64.
4. Fuhrman MP, Charney P, Mueller CM. Hepatic proteins and nutrition assessment. J Am Diet Assoc. 2004; 104:1258-1264.
5. Mueller C, Compher C, Ellen D; and the A.S.P.E.N. Clinical Guidelines: Nutrition Screening, assessment, and intervention in adults. JPEN. Jan 2011; 35(1):16-24.
6. Drover JW, Dhaliwal R, Weitzel L, et al. Perioperative use of arginine-supplemented diets: a systemic review of the evidence. JACS. 2011; 212(3):385-399.
7. Marimuthu K, Varadhan KK, Ljungqvist O, and Lobo DN. A meta-analysis of the effect of combinations of immune modulating nutrients on outcome in patients undergoing major open gastrointestinal surgery. Ann Surg. 2012; 255:1060-1068.