350 Identifying Malnutrition in Emergency General Surgery (EGS): A Systematic Review

Abstract Aim Emergency general surgery (EGS) practice is high risk. Surgery is a key part of treatment, with resultant catabolic stress and frequent need for nutritional support. Aims of this study were to examine the current methods of defining and determining malnutrition in EGS. This included examining the use of nutrition screening and assessment tools, and other measures of malnutrition. Method Medline, Embase, CINAHL, trial registries and relevant journals published between January 2000 and January 2022 were searched for studies of adult patients with any EGS diagnosis, managed operatively or conservatively with an assessment of nutritional status. Mixed populations were included if more than 50% of patients were EGS or EGS results could be separately extracted. Studies whereby patients had received nutritional support were excluded. Results From 6,700 studies screened, 324 full texts were retrieved, and 31 were included in the analysis. A definition of malnutrition was provided in 75% (n = 23) of studies, with nutritional status being determined by a variety of methods. Seven nutrition screening tools and nine ‘assessment’ tools were reported. To define malnutrition, the most commonly used primary or secondary marker of nutritional status was body mass index followed by albumin level. Conclusions Wide variation exists in approaches to identify malnutrition risk in EGS patients, using a range of tools and nutrition markers. Future studies should seek to standardise nutrition screening and assessment in the EGS setting as two discrete processes. This will permit better understanding of malnutrition risk in surgical patients.