Nutritional evaluation and care in coloproctology

Abstract

Protein calorie malnutrition (PCM) is prevalent in 30-80% of hospitalized patients in North America and Europe [9, 12, 16]. It is regarded as primary when it results from inadequate food intake, as usually happens in developing countries, and secondary when it is caused by illness, leading to decreased calorie and protein intake and increased nutrient losses and/or requirements. Severe PCM has deleterious physiologic consequences affecting nearly every organ system. Malnourished surgical patients are at greater risk for postoperative morbidity and mortality than well-nourished patients undergoing similar operations (Table 12.1). Several studies have shown that preoperative nutritional support in patients with severe depletion results in a reduction in major complications, thus justifying the need for evaluation of such patients and administration of perioperative nutritional support [26, 33, 36]. © 2010 Springer-Verlag Berlin Heidelberg.