title: Preoperative nutrition status and postoperative outcome in elderly general surgery patients: a systematic review.
abstract: BACKGROUND
  Poor nutrition status is considered a risk factor for postoperative complications in the adult population. In elderly patients, who often have a poor nutrition status, this relationship has not been substantiated. Thus, the aim of this systematic review was to assess the merit of preoperative nutrition parameters used to predict postoperative outcome in elderly patients undergoing general surgery.
  
  
  METHODS
  A systematic literature search of 10 consecutive years, 1998-2008, in PubMed, EMBASE, and Cochrane databases was performed. Search terms used were nutrition status, preoperative assessment, postoperative outcome, and surgery (hip or general), including their synonyms and MeSH terms. Limits used in the search were human studies, published in English, and age (65 years or older). Articles were screened using inclusion and exclusion criteria. All selected articles were checked on methodology and graded.
  
  
  RESULTS
  Of 463 articles found, 15 were included. They showed profound heterogeneity in the parameters used for preoperative nutrition status and postoperative outcome. The only significant preoperative predictors of postoperative outcome in elderly general surgery patients were serum albumin and ≥ 10% weight loss in the previous 6 months.
  
  
  CONCLUSIONS
  This systematic review revealed only 2 preoperative parameters to predict postoperative outcome in elderly general surgery patients: weight loss and serum albumin. Both are open to discussion in their use as a preoperative nutrition parameter. Nonetheless, serum albumin seems a reliable preoperative parameter to identify a patient at risk for nutrition deterioration and related complicated postoperative course.
authors.affiliation: Department of Surgery, Medical Center Alkmaar, Alkmaar, The Netherlands.
authors.forename: Mireille F M
authors.initials: MF
authors.lastname: van Stijn
authors.forename: Ines
authors.initials: I
authors.lastname: Korkic-Halilovic
authors.forename: Marjan S M
authors.initials: MS
authors.lastname: Bakker
authors.forename: Tjeerd
authors.initials: T
authors.lastname: van der Ploeg
authors.forename: Paul A M
authors.initials: PA
authors.lastname: van Leeuwen
authors.forename: Alexander P J
authors.initials: AP
authors.lastname: Houdijk
mesh_terms: D006801:Humans; D044342:Malnutrition / Q000150:complications* / Q000378:metabolism; D009752:Nutritional Status; D011183:Postoperative Complications / Q000209:etiology*; D012709:Serum Albumin / Q000378:metabolism*; D015431:Weight Loss
chemical_list: D012709:Serum Albumin