Nutritional assessment and clinical course in 112 elective surgical patients

Recent Swedish reference values in anthropometry and delayed hypersensitivity (DH) were applied in the nutritional assessment of 112 surgical patients. The presence of three or more subnormal variables indicating malnutrition was found in 28% of all patients, and in 52% of those with malignant disease. The anthropometric variables revealed deficits in fat stores and muscle in 26 and 6%, respectively. Plasma protein determinations indicated malnutrition in 6-49%. DH skin testing revealed a subnormal response in 17% of the patients. Ten of the 79 operated patients had postoperative complications. Malnutrition was found preoperatively in six of these. The malnourished patients had a 5.5 times higher complication rate compared to the well-nourished (p less than 0.01). Subnormal values in albumin, prealbumin or DH were associated with a statistically significantly increased complication rate. Regression analysis showed correlations between the anthropometric measurements and plasma protein levels. Furthermore, DH correlated with triceps skin fold, albumin, prealbumin and cholinesterase.