La valutazione dello stato di nutrizione nel paziente chirurgico.

Since malnutrition has been demonstrated as increasing surgical risk in terms of post-operative morbidity and mortality, simple and feasible methods of evaluating nutritional status have been investigated. Epidemiological studies, carried out mainly in populations with gastrointestinal diseases, allowed selection of some simple indices (weight loss, albumin, transferrin, circulating lymphocytes and delayed hypersensitivity response to cutaneous antigens) which are useful in assessing the patient's altered nutritional status. The same results can be obtained by clinical examination only, if this is conducted by a trained physician. The conclusions of investigations of nutritional assessment parameters and of multiparametric indices are controversial. Non-nutritional factors are often involved in the occurrence of post-operative complications, interfering with the predictive value of the nutritional status indicators.