Perioperative nutrition optimization: a review of the current literature

Tool	Element	Forms of assessment	Efficiency assessment
NRS-2002	Impaired nutritional status (weight loss, BMI, and food intake) and disease severity	Marking Scheme	Very effective
MUST	BMI, weight loss in the past 3–6 months, and acute illness of >5 days duration	Marking Scheme	Very effective
NMA	BMI, recent weight loss status, diet, nutrient absorption status, physical health status	Marking Scheme	Effective
SGA	Medical history (weight change, dietary intake, gastrointestinal symptoms, functional capacity, and metabolic stress) and physical examination (subcutaneous fat loss, muscle wasting, edema, and ascites).	Questionnaire	Effective
PG-SGA	Subjective patient assessment: weight, food intake, symptoms, activities, and body functions + Medical staff assessment: relationship between disease and nutritional needs, metabolic needs, physical examination	Questionnaire	Effective
PNI	10 × serum albumin (g/dL) + 0.005 × total lymphocyte count (cells/mm³)	Formula	Simple and fast, but requires lab parameters
NRI	1.489 × serum albumin (g/L) + 41.7 × (current weight/usual weight)	Formula	Simple and fast, but requires lab parameters
NRS	Unintentional weight loss in the past 3 months, BMI, appetite, ability to eat or retain food, and severity of disease	Marking Scheme	Very effective
COUNT	Serum albumin level (Ag/dL), total lymphocyte count (n/mm³), total cholesterol concentration (mg/dL)	Marking Scheme	Simple and fast, but requires lab parameters

Nutritional support pathway and indication	Contraindication
Enteral Nutrition
Preoperative and postoperative supportive care for malnourished patients	Complete mechanical intestinal obstruction, paralytic intestinal obstruction
Difficulty in swallowing or chewing	Gastrointestinal bleeding and perforation
Disorders of consciousness and coma	Abdominal or intestinal infection
Stable stage of digestive tract disease	Early stage and shock state of severe infection, trauma and other stress states
High catabolic state	Early stage of short bowel syndrome, high flow intestinal fistula
chronic wasting disease	Severe vomiting, diarrhea, malabsorption
Parenteral nutrition
Mechanical obstruction and paralytic intestinal obstruction caused by EN	Patients with normal gastrointestinal function or indications for EN
Short bowel syndrome	Cardiovascular dysfunction or severe metabolic disorder
Absorptive dysfunction	High intestinal fistula, congenital malformation of gastrointestinal tract, and excessive gastrointestinal reaction during radiotherapy
Severe vomiting and diarrhea	Severe burns and severe infections
Severe malnutrition	Ulcerative colitis, localized enteritis, long-term diarrhea
Hyperemesis gravidarum	Necrotizing pancreatitis, acute renal failure, liver failure
High risk of aspiration	Brain death or irreversible coma

Perioperative nutrition optimization: a review of the current literature†