Évaluation de l’état nutritionnel péri-opératoire |
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Authors: | Ronan Thibault Daniel Francon Servais Eloumou Marie-Astrid Piquet |
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Affiliation: | a Service d’hépato-gastro-entérologie et assistance nutritionnelle, UMR 1280 physiologie des adaptations nutritionnelles, Inra, Hôtel-Dieu, université de Nantes, CRNH Nantes, institut des maladies de l’appareil digestif, CHU de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 01, France;b Département anesthésie réanimation, institut Paoli-Calmettes, CRLCC, 13009 Marseille, France;c Service d’hépato-gastro-entérologie et nutrition, CHU de Caen, 14033 Caen, France |
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Abstract: | In surgical patients, malnutrition is associated with an increase in morbidity, mortality, length of stay and health care costs, and has an impact on quality of life. Before surgery, the risk of malnutrition is depending on patient-related factors (age, associated diseases, on-going symptoms, duration of pre-operative hospital stay), surgical procedure, and medical treatment (radiotherapy, chemotherapy, corticoid treatment). The early screening and management of malnutrition are mandatory during the peri-operative period, with the aim to improve post-operative prognosis and clinical outcome. The nutritional assessment is based on the research of weight loss, the calculation of body mass index and the research of an hypoalbuminemia, all of them having a negative impact on postoperative prognosis. The Nutritional Risk Index (NRI) is also of strong prognostic value. We propose a stratification of the nutritional risk indicating several levels of surgical risk. The organization, the planning and the traceability in the medical record of the nutritional assessment should allow optimizing the management and the clinical outcome of surgical patients. The pre-operative consultation of anaesthesia could be the privileged time to perform the screening of malnutrition and to plan its management, if they were not previously performed by the medico-surgical team. |
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Keywords: | Mots clé s: Dé nutrition É valuation nutritionnelle Chirurgie Albumine Plasmatique Consultation d’ anesthé sieUndernutrition Nutritional assessment Surgery Serum albumin Anaesthesia |
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