PD060 - MULTICENTRE PROSPECTIVE STUDY ON THE DIAGNOSTIC AND PROGNOSTIC VALIDITY OF MALNUTRITION ASSESSMENT TOOLS IN SURGERY

PD060

MULTICENTRE PROSPECTIVE STUDY ON THE DIAGNOSTIC AND PROGNOSTIC VALIDITY OF MALNUTRITION ASSESSMENT TOOLS IN SURGERY

G. Petra^1,*, E. Kritsotakis ², N. Gouvas³, D. Schizas⁴, M. Karanikas⁵, G. Pappas-Gogos⁶, G. Stylianidis⁷, G. Zacharioudakis⁸, A. Laliotis⁹, G. Christodoulidis¹⁰, I. Kehagias¹¹, K. Lasithiotakis¹ on behalf of MATS collaborators

¹Department of General Surgery, Medical School, University Hospital of Heraklion, University of Crete, ²Laboratory of Biostatistics, Medical School, University of Crete, Heraklion, Greece, ³Department of Surgery, School of Medicine, University of Cyprus, Nicosia, Cyprus, ⁴1st Department of Surgery, Laikon Hospital, National and Kapodistrian University of Athens, Athens, ⁵1st Surgical Department, Faculty of Medicine, ⁶2nd Surgical Department, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, Alexandroupolis, ⁷2nd Department of Surgery, Evangelismos General Hospital, Athens, ⁸5th Surgical Department, Ippokrateio General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, ⁹Department of Surgery, Venizeleio Hospital, Heraklion, ¹⁰ Department of Surgery, School of Medicine, University of Thessaly, Larissa, ¹¹Department of Surgery, School of Medicine, University of Patras, Patras, Greece

Rationale: Malnutrition is an important modifiable risk factor for postoperative morbidity, but the optimal screening method is unclear. Several common tools for preoperative nutrition assessment were evaluated comprehensively in an ample pool of surgical patients.

Methods: This is a prospective multicentre cohort study (NCT 05393752). Consecutive patients undergoing elective or emergency major abdominal surgery in 12 Greek hospitals between January 2022 and December 2023 were included. GLIM, MNA-SF, MST, MUST, NRI, NRS-2002, PONS and SNAQ were applied for malnutrition risk assessments. SGA was used as a reference standard for malnutrition diagnosis. Demographics, type/site/magnitude of the operation, American Society of Anesthesiologist class, presence/stage of malignancy as well as 30 day postoperative mortality and complications based on Clavien-Dindo classification were recorded.

Results: 1,649 patients (66.3±13.8 years; 42% females) were examined. SGA identified 562 (34.1%) malnourished patients, of whom 54 (3.3%) were severely malnourished. The most common site of operation was the lower gastrointestinal tract (59%) followed by the upper gastrointestinal tract (20%). 31% of the operations were emergent, and 68% involved a diagnosis of cancer. The mean length of hospitalisation was 12.6±21.7 days and 323 (20%) patients had a serious complication within 30 days of the operation. As binary classifiers, MNA-SF (OR=30.2; CI 20.2–45.1) and MUST (OR=16.1; CI 12.4–21.1) had the highest diagnostic odds ratios, but only MUST had both sensitivity and specificity close to 80%. MUST performed well in construct and prognostic validity appraisals.

Conclusion: Wide variation exists in approaches to identify malnutrition risk in surgical patients using a range of tools. This large multihospital study supports routinely using MUST as the most valid nutritional screening tool in surgery

Disclosure of Interest: None declared