[Pre-operative nutritional status as a morbidity factor in surgical patients]

Malnutrition is very common in critically ill patients. According to the available data, a high percentage of patients (30-60%) suffers from some degree of malnutrition, and in 10-15% of patients malnutrition can be very severe. Patient's nutritional status usually worsens during hospitalization. In malnutrition, the functions of all organ systems change. Surgical treatment is a stress for the body, which leads to the predominant catabolic response with accelerated decomposition of the non-fat tissue, resulting in enhanced gluconeogenesis and negative nitrogen balance, which further compromise body's vital functions. Due to such physiological effects, malnutrition is followed by increased number of complications of the underlying disease, higher mortality rate, prolonged hospitalization and increased treatment costs. Malnutrition is common in clinical practice, so at the time of the admission, all patients should be checked for signs of malnutrition. After noticing the presence of the increased risk, it is necessary to make a plan for preoperative nutritional support, in order to prepare the patient optimally for the surgical procedure. It is also necessary to check the factors which might lead to further worsening of the nutritional status of the patient. With adequate screening and therapy, it is possible to improve patients' general condition and the outcome, as well as to reduce the percentage of complications, mortality rate and treatment costs.