title: Perioperative nutrition is still a surgical orphan: results of a Swiss-Austrian survey.
abstract: OBJECTIVE
  There is strong evidence for the beneficial effects of perioperative nutrition in patients undergoing major surgery. We aimed to evaluate implementation of current guidelines in Switzerland and Austria.
  
  
  METHODS
  A survey was conducted in 173 Swiss and Austrian surgical departments. We inquired about nutritional screening, perioperative nutrition and estimated clinical significance.
  
  
  RESULTS
  The overall response rate was 55%, having 69% (54/78) responders in Switzerland and 44% (42/95) in Austria. Most centres were aware of reduced complications (80%) and shorter hospital stay (59%). However, only 20% of them implemented routine nutritional screening. Non-compliance was because of financial (49%) and logistic restrictions (33%). Screening was mainly performed in the outpatient's clinic (52%) or during admission (54%). The nutritional risk score was applied by 14% only; instead, various clinical (78%) and laboratory parameters (56%) were used. Indication for perioperative nutrition was based on preoperative screening in 49%. Although 23% used preoperative nutrition, 68% applied nutritional support pre- and postoperatively. Preoperative nutritional treatment ranged from 3 days (33%), to 5 (31%) and even 7 days (20%).
  
  
  CONCLUSIONS
  Although malnutrition is a well-recognised risk factor for poor post-operative outcome, surgeons remain reluctant to implement routine screening and nutritional support according to evidence-based guidelines.
authors.affiliation: Department of Visceral Surgery, University Hospital CHUV, Lausanne, Switzerland.
authors.forename: F
authors.initials: F
authors.lastname: Grass
authors.forename: Y
authors.initials: Y
authors.lastname: Cerantola
authors.forename: M
authors.initials: M
authors.lastname: Schäfer
authors.forename: S
authors.initials: S
authors.lastname: Müller
authors.forename: N
authors.initials: N
authors.lastname: Demartines
authors.forename: M
authors.initials: M
authors.lastname: Hübner
mesh_terms: D001317:Austria; D004032:Diet; D013505:Digestive System Surgical Procedures; D019983:Guideline Adherence; D006801:Humans; D009752:Nutritional Status; D018529:Nutritional Support; D011182:Postoperative Care; D017410:Practice Guidelines as Topic; D011300:Preoperative Care; D011795:Surveys and Questionnaires; D013557:Switzerland