Perioperative nutrition management as an important component of surgical capacity in low‐ and middle‐income countries

Abstract

SummaryNeeds for surgical care are growing in low-and middle-income countries. Existing surgical care capacity indicators, focusing on the availability of equipment, personnel, and operation and anaesthetic skills, are not intended to evaluate perioperative nutrition management, which influences surgical outcomes. In this narrative review, we describe the prevalence of malnutrition and its clinical consequences among surgical patients in low-and middle-income countries, suggest potential measures to improve nutrition management and discuss the necessity of considering nutrition management as a component of surgical care capacity.

Prevalence and risk factors of preoperative malnutrition risk in older patients and its impact on surgical outcomes: a retrospective observational study

“…36 In this study, we observed an association between the presence of more comorbidities and a higher risk of malnutrition. For instance, the median [interquartile range (IQR)] CCI score of those with a MUST score 0-1 was 4 [3][4][5], while the median CCI score of those with a MUST score C 2 was 6 [4][5][6][7] (Table 2). Likewise, a higher ASA physical status (i.e., ASA C III) and malignancy were also significantly associated with high malnutrition risk.…”

“…4 The reported prevalence of malnutrition in surgical patients ranges widely depending on the type of surgery, their socioeconomic status, the presence of an underlying malignancy, and the choice of screening tool used. 5 Screening for malnutrition risk preoperatively creates an opportunity for these at-risk patients to be identified for nutritional optimization prior to surgery. Nevertheless, it is commonly overlooked because of time and financial constraints, and lack of awareness.…”

Comment on “The Impact of Preoperative Immune Modulating Nutrition on Outcomes in Patients Undergoing Surgery for Gastrointestinal Cancer”

“…In addition, the prevalence of malnutrition for gastrointestinal cancer patients from low-and middle-income countries is higher (5) (6). However eligible studies within these settings are likely to have been omitted as the World Health organization Global Index Medicus databases and clinical trial registries were not included within the search strategy.…”

Risk of malnutrition in general surgical patients

“…Although malnutrition is common in hospitalized patients, it is an important health problem that is often ignored (4). It has been reported that the prevalence of hospital malnutrition exceeds 70% in low and middleincome countries and up to 50% in high-income countries (5). However, it has been stated that the frequency of malnutrition seen in patients may change between 20-50% after admission to the hospital, and more weight loss is observed during the initial stay in patients with undernourishment (4).…”