Abstract. – OBJECTIVE: Surgery is a major
stress factor that activates several inflammatory
and catabolic pathways in man. An appropriate
nutritional status allows the body to react properly
to this stressor and recover in a faster and
more efficient manner. On the other hand, malnutrition
is related to a worse surgery outcome
and to a higher prevalence of comorbidities and
The aims of this study were to evaluate the nutritional
status of patients undergoing major surgery
and investigate the potential correlation between
malnutrition and surgical outcomes.
PATIENTS AND METHODS: Mini Nutritional
Assessment (MNA) and global clinical examination
(including biochemical parameters and
comorbidities existence) were undertaken in 50
consecutive patients undergoing major surgery.
Patients’ clinical conditions were re-evaluated at
3 and 6 days after surgery, recording biochemical
parameters and systemic and/or wound-related
RESULTS: A compromised nutritional status
was present in more than half (54%) of patients
(malnutrition in 10% and risk of malnutrition
in 44% of patients, respectively). Females
were slightly more at risk of malnutrition (48%
vs. 41%, p=NS, females vs. males) and clearly
malnourished (14% vs. 7%, p<0.05, females
vs. males). Age was an independent risk factor
for malnutrition and within the elders’ group (>
80 years old) 16.70% of patients was diagnosed
with malnutrition and 58.3% was at risk of malnutrition.
Systemic complications were registered
in all patients both at 3 and 6 days after surgery.
However, well-nourished and at-risk of malnutrition
patients had earlier complications that only
partially resolved within six days after the operation.
Malnourished patients showed fewer complications
at the 3rd post-surgery follow-up day
but had a worse outcome six days after surgery.
CONCLUSIONS: Older age and but not female
sex are independent risk factors for malnutrition
development in patients undergoing major
surgery. More interestingly, more than half
of patients with an impaired nutritional status
presented a less appropriated stress response
to surgery. These data suggest that nutritional
status assessment may be important to recognize
patients at potential risk of surgical complications
and that early nutritional interventions
must be promptly arranged.
- nutritional status, malnutrition