Description
BACKGROUNDMalnutrition is a complex diagnosis in an older patient who may have several co-morbidities alongside a presenting surgical complaint. Addressing any deficiencies may improve older patients’ surgical outcome and reduce the risk for increased length of stay and mortality (Ashmore et al, 2023). At LTHT, patients undergoing emergency abdominal surgery should undergo an assessment of the risk of malnutrition upon admission to the surgical department using the Malnutrition Universal Screening Tool (MUST) (NICE, 2017). This assessment by registered professionals should trigger a response when patients are categorised as high-risk, with subsequent prescribing of nutritional support and referral to dietetic services.
AIM
This clinical audit had 2 aims:
1. To determine whether older patients undergoing emergency abdominal surgery were identified as being at risk of malnutrition using MUST scoring system.
2. To evaluate whether patients received appropriate nutritional support to address deficiencies if they were classified as high-risk as per the recommendations of the NICE (2017) guidelines.
METHODS
Patients aged 65 years or older undergoing emergency laparotomy between January 1, 2021 and December 31, 2022 were included. The patient electronic records were reviewed for the MUST score
recorded upon admission. Whether there was prescribing of nutritional supplementation or dietetic referral made following the identification of a high MUST score was also evaluated.
RESULTS
Of the 300 patients included in this clinical audit, 98% had a recorded MUST score. Of these, 114 patients had a high-risk MUST score, but 35% of these high-risk patients did not undergo a dietetic review. Additionally, 24% of high-risk patients received neither oral nor parenteral supplementation.
CONCLUSIONS
High-risk MUST scores in older patients are readily available to surgical teams within the electronic patient record. However, this does not consistently lead to interventions that address nutritional deficiencies, by either nutritional supplement prescribing or expert dietetic review.
| Period | 10 Jul 2025 |
|---|---|
| Event title | Leeds Teaching Hospitals NHS Trust Research and Innovation Conference : NHS R&I 2025 |
| Event type | Conference |
| Location | Leeds, United KingdomShow on map |