Nutritional screening of patients undergoing surgery or oncological treatment in four Croatian hospitals.

AIM To identify malnourishment of surgical and oncologic patients or those at risk of becoming malnourished at four hospital centers in Croatia by use of nutritional screening questionnaire developed specifically for the purpose of this study. METHOD The study included 1639 adult patients: 1475 scheduled for various surgical treatments and 164 oncologic patients receiving primary or adjuvant radio- and/or chemotherapy. The nutritional screening questionnaire consisted of data on recently reduced food intake and weight loss, body mass index (BMI), estimated period of perioperative fasting or oncologic disease status, categorization of surgical procedure, and additional stress expected. Each component was rated on a 0-2 or 0-3 scale. A score of seven points was chosen as the borderline between patients at risk of malnutrition (score <or=7) and those at no such risk (score 8-11). The questionnaire also included data on blood albumin, blood urea, blood lymphocyte count, blood creatinine, and overall patient evaluation by the physician. RESULTS Reduced food intake and weight loss were reported by 20% and 33% of the patients, respectively. Median BMI was 26 (range, 23.2-28.9) and underweight BMI values (<20) were found in 7% of the patients. Screening questionnaire score of <or=7, indicating the risk of malnutrition, was obtained in 23% of 1639 patients. Decreased albumin and lymphocytes were found in 10% and 17% of the patients, respectively. Increased urea and creatinine were found in 13% and 7% of the patients, respectively. Of the 288 patients examined by the physician, 41% were assessed as at risk of malnutrition and 9% as malnourished. CONCLUSION Nutritional screening questionnaire could be used for the identification of patients being at risk of malnutrition. An adequate prospective study is required for its final validation.