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Perioperative nutrition is still a surgical orphan: results of a Swiss–Austrian survey

Abstract

Background/Objectives:

There is strong evidence for the beneficial effects of perioperative nutrition in patients undergoing major surgery. We aimed to evaluate implementation of current guidelines in Switzerland and Austria.

Subjects/Methods:

A survey was conducted in 173 Swiss and Austrian surgical departments. We inquired about nutritional screening, perioperative nutrition and estimated clinical significance.

Results:

The overall response rate was 55%, having 69% (54/78) responders in Switzerland and 44% (42/95) in Austria. Most centres were aware of reduced complications (80%) and shorter hospital stay (59%). However, only 20% of them implemented routine nutritional screening. Non-compliance was because of financial (49%) and logistic restrictions (33%). Screening was mainly performed in the outpatient's clinic (52%) or during admission (54%). The nutritional risk score was applied by 14% only; instead, various clinical (78%) and laboratory parameters (56%) were used. Indication for perioperative nutrition was based on preoperative screening in 49%. Although 23% used preoperative nutrition, 68% applied nutritional support pre- and postoperatively. Preoperative nutritional treatment ranged from 3 days (33%), to 5 (31%) and even 7 days (20%).

Conclusions:

Although malnutrition is a well-recognised risk factor for poor post-operative outcome, surgeons remain reluctant to implement routine screening and nutritional support according to evidence-based guidelines.

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Acknowledgements

We thank Giustina Mariotti and Bettina Scuffi for their valuable help in data acquisition and management.

We kindly thank all responding centres:

Switzerland: University Basel, University Bern, University Lausanne, University Zürich, Aarau, Aarberg, Affoltern, Altdorf, Biel, Baden, Bellinzona, Bruderholz Basel, Bern Tiefenau, Burgdorf, Bülach, Chur, Davos, Frauenfeld, Fribourg, Glarus, Grabs, Herisau, Ilanz, Interlaken, La Chaux-de-Fonds, Lachen, Laufen, Liestal, Luzern, Mendrisio, Monthey, Morges, Münsingen, Münsterlingen, Olten, Payerne, Rheinfelden, Riaz, Samedan, Sarnen, Schaffhausen, Schlieren, Sion, St Gallen, Sursee, Triemli Zürich, Uster, Waid Zürich, Wetzikon, Winterthur, Yverdon, Zofingen, Zollikerberg, Zug.

Austria: University Innsbruck, University Wien, Bad Aussee, Barmherzige Brüder Salzburg, Barmherzige Schwestern Wien, Braunau, Bregenz, Bruck a.d. Mur, Deutschlandsberg, Dornbirn, Donauspital Wien, Eisenstadt, Feldkirch-Tisis, Elisabethinen Graz, Elisabethinen Linz, Elisabethinen Klagenfurt, Floridsdorf Wien, Friesach, Gmunden, Hainburg/Donau, Hall in Tirol, Hartberg, Hollabrunn, Horn, Judenburg, Kufstein, Lienz, LKH Graz, Mistelbach, Neunkirchen, Rottenmann, Scheibbs, Schladming, Schwarzach im Pongau, St. Johann in Tirol, Tamsweg, Tulln, Villach, Vöcklabruck, Waidhofen an der Ybbs, Wels, Wiener Neustadt.

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Correspondence to M Hübner.

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The authors declare no conflict of interest.

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Contributors: MH and SM designed the study. FG, MH, MS and YC carried out the study, performed data analyses and drafted the manuscript. ND conceived the study, and participated in its design and coordination and helped to draft the manuscript. All authors read and approved the final manuscript.

Supplementary Information accompanies the paper on European Journal of Clinical Nutrition website

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Grass, F., Cerantola, Y., Schäfer, M. et al. Perioperative nutrition is still a surgical orphan: results of a Swiss–Austrian survey. Eur J Clin Nutr 65, 642–647 (2011). https://doi.org/10.1038/ejcn.2011.13

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  • DOI: https://doi.org/10.1038/ejcn.2011.13

Keywords

  • immune enhancing
  • immunonutrition
  • screening
  • surgery
  • complications
  • infections

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