Perioperative Nutritional Management of Elderly Patients

The nutritional status of patients undergoing surgery is very relevant as it represents a modifiable risk factor for postoperative outcomes. Malnutrition is frequent among elderly patients, which often carry other overlapping conditions such as comorbidities and poor functional status. For this reason, it is very important to screen patients preoperatively for nutritional and functional status and tailor perioperative strategies accordingly. Malnourished patients can be identified through simple screening tools that include questions focused on BMI, weight loss, and dietary intake. Surgery may also be delayed to implement a nutritional intervention to potentially reduce postoperative morbidity. Preoperative nutritional interventions to enhance patient nutritional status aim at meeting an adequate protein target by improving diet or adding high-protein oral nutritional supplements, since proteins are the most used substrate in surgical stress situations. If the oral route is not effective, nutritional interventions include enteral feeding and parenteral nutrition.