Nutritional risk and status of surgical patients; the relevance of nutrition training of medical students

Background: The prevalence of undernutrition among surgical patients is thought to be high, and negatively influencing outcomes. However, recent evidence shows the increase of overweight/obesity in hospitalised patients. Aims: A pilot cross-sectional study was conducted in 50 patients of a Surgical Department of the University Hospital of Santa Maria (CHLN) that aimed: 1) to assess nutritional risk and status through validated methods; 2) to explore the presence of overweight/obesity; 3) to evaluate the prevalence of metabolic risk associated with obesity. Methods: Nutritional risk was assessed by Malnutrition Universal Screening Tool (MUST), nutritional status by Body Mass Index (HMI), waist circumference (WC), & Subjective Global Assessment (SGA). Statistical significance was set for p < 0.05. Results: 58% of patients were overweight/obese and 54% had high cardio-metabolic risk, according to waist circumference; 30% of patients had significantly lost weight (>= 5%), whereas 28% gained weight. By MUST, 46% of patients were at low risk and 34% at high risk. By SGA, 58% patients were well nourished and 40% had moderate/severe undernutrition. A longer length of stay was associated with moderate/high risk by MUST, and undernutrition by SGA (p = 0.01). Conclusions: Undernutrition or obesity pose surgical risks. The lack of nutrition discipline in the medical curricula, limits the multiprofessional management and a better understanding of the more adequate approaches to these patients. Further, the change in the clinical scenario argues for more studies to clarify the prevalence and consequences of sarcopenic obesity in surgical patients. (Nutr Hosp. 2012;27:1086-1091) DOI:10.3305/nh.2012.27.4.5826