Evidence map›Paper›PMID 30893119›Full record

ReviewCurrent opinion in anaesthesiology2019

The malnourished surgery patient: a silent epidemic in perioperative outcomes?

David G A Williams, Jeroen Molinger, Paul E Wischmeyer

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Current opinion in anaesthesiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 3 pooled it
8.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 3 syntheses or guidelines pooled it, 145 citations in OpenAlex.

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  5. From Hip and Knee to Shoulder: Is the Obesity Paradox Becoming a Surgical Reality?The Journal of bone and joint surgery. American volume · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 2 countries.

David G A WilliamsDepartment of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
Jeroen MolingerDepartment of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
Paul E WischmeyerDepartment of Anesthesiology, Duke University School of Medicine, Durham, North Carolina, USA.
Duke University · USCodarts Rotterdam · NL

Funding

INTEGRATED TRAINING IN ANESTHESIOLOGY RESEARCHT32GM008600 · NIGMS · DUKE UNIVERSITY · PI Miriam Treggiari · 1996 to 2026
$6.6M
Supplemental Parenteral Nutrition to Reduce Death in Malnourished ICU PatientsR34HL109369 · NHLBI · UNIVERSITY OF COLORADO DENVER · PI HEYLAND, DAREN KEITH, WISCHMEYER, PAUL E · 2012 to 2014
$568k
NHLBI NIH HHS R34 HL109369NIGMS NIH HHS T32 GM008600
6 · The paper itself

Abstract

purpose of reviewAs many as two of every three major surgery patients are malnourished preoperatively - a diagnosis rarely made and treated even less frequently. Unfortunately, perioperative malnutrition is perhaps the least often identified surgical risk factor and is among the most treatable to improve outcomes. RECENT

findingsTwo important perioperative nutrition guidelines were published recently. Both emphasize nutrition assessment as an essential component of preoperative screening. The recently published perioperative nutrition screen (PONS) readily identifies patients at malnutrition risk, allowing for preoperative nutritional optimization. The use of computerized tomography scan and ultrasound lean body mass (LBM) evaluation to identify sarcopenia associated with surgical risk and guide nutrition intervention is garnering further support. Preoperative nutrition optimization in malnourished patients, use of immunonutrition in all major surgery, avoidance of preoperative fasting, inclusion of postoperative high-protein nutritional supplements, and early postoperative oral intake have all recently been shown to improve outcomes and should be utilized. SUMMARY: The recent publication of new surgical nutrition guidelines, the PONS score, and use of LBM assessments will allow better identification and earlier intervention on perioperative malnutrition. It is essential that in the future no patient undergoes elective surgery without nutrition screening and nutrition intervention when malnutrition risk is identified.

Indexed as

Nutrition AssessmentEnteral NutritionFastingHumansMalnutritionPerioperative CarePostoperative ComplicationsPractice Guidelines as TopicPreoperative PeriodPrevalenceRisk FactorsSurgical Procedures, Operative

Identifiers

PMID30893119
PMCPMC6760866
OpenAlexW2927192527

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.