Preoperative Nutrition in Elderly Patients and Postoperative Outcome

  • Julia van Wissen
  • Nathalie Bakker
  • Colin Heus
  • Alexander P. J. Houdijk
Reference work entry


Malnutrition is a frequent problem in elderly patients, especially in the nursing home population. The cause of malnutrition is often multifactorial and includes biological, physiological, and psychological changes due to aging. The nutritional status of elderly people has a great effect on their general health and outcome after hospital admission and surgery. Malnutrition, resulting in loss of fat-free mass, loss of muscle mass, and vitamin deficiencies, is associated with significantly increased morbidity and mortality. The elderly surgical patient represents an increasing part of the total surgical population. Elderly patients are more at risk to develop postoperative complications because of an altered physiology, higher risk of malnutrition, and more comorbidities. Emergency operations are more common in elderly patients and of all operations the most riskful. There are different methods available to determine nutritional status, including questionnaires, anthropometric measurements, biochemical parameters, devices to measure body composition, and measures of muscle strength.

There are different strategies to improve the nutritional status, including complete nutrition such as enteral and parenteral feeding and supportive measures like carbohydrate drinks, vitamin supplementation, enriched protein drinks, and immunonutrition.

The nutritional status of the elderly surgical patient should be assessed by a combination of methods, including questionnaires and devices to measure body composition in order to be specific. With an adequate nutritional status, surgical outcome is easier to predict and malnutrition can be treated accurately. There is a need for more research with elderly surgical patients in the field of perioperative nutritional support on predictive measures of nutritional status.


Nutritional Status Pressure Ulcer Mini Nutritional Assessment Handgrip Strength Malnutrition Universal Screen Tool 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

List of Abbreviations


Acute respiratory distress syndrome


American Society of Parenteral and Enteral Nutrition


Bioelectrical impedance analysis


Body mass index


Chronic obstructive pulmonary disease


Computed tomography


Dual-energy X-ray absorptiometry

Elderly patient

≥65 years of age


Interventions with specific nutrients that have potential to modulate the activity of the immune system


The condition that develops with a diet in which certain nutrients are lacking, in excess or in the wrong proportions, to maintain healthy tissue and organ function


Mini Nutritional Assessment


Malnutrition Universal Screening Tool

Pressure ulcer

Localized injury to the skin and/or underlying tissue that usually occurs over a bony prominence as a result of pressure or pressure in combination with shear and/or friction

Refeeding syndrome

In significantly malnourished patients, the initial stage of oral, enteral, or parenteral nutritional replenishment causes electrolyte and fluid shifts that may precipitate disabling or fatal medical complications. The refeeding syndrome is marked by hypophosphatemia, hypokalemia, hypomagnesemia, vitamin and trace mineral deficiencies, volume overload, and edema


Short Nutritional Assessment Questionnaire


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Julia van Wissen
    • 1
    • 2
  • Nathalie Bakker
    • 1
    • 2
  • Colin Heus
    • 1
  • Alexander P. J. Houdijk
    • 1
    • 2
  1. 1.Department of SurgeryMedical Center AlkmaarAlkmaarThe Netherlands
  2. 2.Trial Center Holland HealthAlkmaarThe Netherlands

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