Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 5;7(5):zrad086.
doi: 10.1093/bjsopen/zrad086.

Identifying malnutrition in emergency general surgery: systematic review

Daniel L Ashmore  1   2 , Adil Rashid  1 , Timothy R Wilson  2 , Vanessa Halliday  1 , Matthew J Lee  1
Affiliations

Identifying malnutrition in emergency general surgery: systematic review

Daniel L Ashmore et al. BJS Open. .

Abstract

Background: Emergency general surgery practice is high risk. Surgery is a key part of treatment, with resultant catabolic stress and frequent need for nutritional support. The aim of this study was to examine the current methods of defining and determining malnutrition in emergency general surgery. This included examining the use of nutrition screening and assessment tools and other measures of malnutrition.

Methods: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, trial registries, and relevant journals published between January 2000 and January 2022 were searched for studies of adult patients with any emergency general surgery diagnosis, managed conservatively or operatively, with an assessment of nutritional status. Mixed populations were included if more than 50 per cent of patients were emergency general surgery patients or emergency general surgery results could be separately extracted. Studies in which patients had received nutritional support were excluded. The protocol was registered with PROSPERO, the international prospective register of systematic reviews (CRD42021285897).

Results: From 6700 studies screened, 324 full texts were retrieved and 31 were included in the analysis. A definition of malnutrition was provided in 23 studies (75 per cent), with nutritional status being determined by a variety of methods. A total of seven nutrition screening tools and a total of nine 'assessment' tools were reported. To define malnutrition, the most commonly used primary or secondary marker of nutritional status was BMI, followed by albumin level.

Conclusion: Wide variation exists in approaches to identify malnutrition risk in emergency general surgery patients, using a range of tools and nutrition markers. Future studies should seek to standardize nutrition screening and assessment in the emergency general surgery setting as two discrete processes. This will permit better understanding of malnutrition risk in surgical patients.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
PRISMA flow diagram EGS, emergency general surgery.
Fig. 2
Fig. 2
Mapping of criteria used to define malnutrition
See this image and copyright information in PMC

References

    1. NHS Digital . Hospital Episode Statistics. Hospital Admitted Patient Care Activity, 2018-2019: Main Specialty. https://digital.nhs.uk/data-and-information/publications/statistical/hos...
    1. Gale SC, Shafi S, Dombrovskiy VY, Arumugam D, Crystal JS. The public health burden of emergency general surgery in the United States: a 10-year analysis of the nationwide inpatient sample–2001 to 2010. J Trauma Acute Care Surg 2014;77:202–208 - PubMed
    1. Ramsay G, Wohlgemut JM, Jansen JO. Emergency general surgery in the United Kingdom: a lot of general, not many emergencies, and not much surgery. J Trauma Acute Care Surg 2018;85:500–506 - PubMed
    1. Thompson AM, Stonebridge PA. Building a framework for trust: critical event analysis of deaths in surgical care. BMJ 2005;330:1139–1142 - PMC - PubMed
    1. Havens JM, Columbus AB, Seshadri AJ, Olufajo OA, Mogensen KM, Rawn JDet al. . Malnutrition at intensive care unit admission predicts mortality in emergency general surgery patients. JPEN J Parenter Enteral Nutr 2018;42:156–163 - PubMed

Publication types