A clinical audit of assessment of the risk of malnutrition and the subsequent nutritional support prescribed for older emergency laparotomy patients

Angela Windle, Dermot Burke, Theocharis Ispoglou, Sherena Nair

Research output: Contribution to journalMeeting Abstractpeer-review


Patients should have assessment of the risk for malnutrition on admission using a Malnutrition Universal Screening Tool (MUST) and this should trigger a response if patients are categorised as high risk (National Institute for Health Care and Excellence, 2017). This clinical audit sought to identify if older patients undergoing emergency laparotomy were identified as at risk of malnutrition with subsequent interventions to address protein and energy deficiencies.
Patients entered onto the National Emergency Laparotomy Audit (NELA) database who were over 65 years of age during 1/1/21 to 31/12/22 were included. The patient records were screened for the MUST score on admission and whether nutritional supplementation was prescribed, or dietetic referral made, following the recording of a high-risk MUST score.
Three hundred patients were included in the audit with 99.3% of the patients having a MUST score recorded on admission. One hundred and fourteen patients recorded a high MUST score, with 35% of the high MUST patients not receiving a dietetic review and 24% receiving neither oral nor parenteral supplementation. Mortality at 30 days was 13.9%. The wide variety of supplementation prescribed was changed to a protein and energy-based supplement upon dietetic review.
MUST scores are available to surgical teams, but high-risk scores do not always trigger an intervention to address deficiencies in older NELA patients. A protocol to ensure consistent approaches to supplementation before dietetic review would reduce variation and education of prescribers is needed to address the importance of prescribing protein-based supplements is needed.
Original languageEnglish
Article numberThTP5.10
Number of pages1
JournalBritish Journal of Surgery
Issue numberIssue Supplement 6
Early online date21 Aug 2023
Publication statusPublished - 1 Sep 2023
Externally publishedYes
EventAnnual Congress of the Association of Surgeons of Great Britain and Ireland - Harrogate, United Kingdom
Duration: 17 May 202319 May 2023

Cite this