Nutritional screening and support in older patients undergoing emergency colorectal surgery: a clinical audit
Angela Windle, Dermot Burke, Theocharis IspoglouBackground
Malnutrition is a common, yet modifiable risk factor in older surgical patients, and is associated with higher postoperative morbidity and mortality. National guidance recommends that nutritional risk be assessed using validated tools such as the Malnutrition Universal Screening Tool (MUST) with clear care pathways for dietetic support and oral nutritional supplementation, where needed.
Aims
To evaluate how effectively MUST scores are recorded and acted on in older patients undergoing emergency colorectal surgery.
Methods
A retrospective clinical audit of patients aged ≥65 years who underwent emergency laparotomy (January 2021—December 2022) at a UK NHS teaching hospital was conducted. Electronic records were reviewed for MUST scores, dietetic referrals and oral nutritional supplementation prescriptions.
Results
Of 300 patients, 99% had a recorded MUST score. Among 114 patients identified as high-risk, 35% did not receive a dietetic review, and 24% received no nutritional supplementation.
Conclusions
Although screening compliance was high, many high-risk patients did not receive appropriate follow up. These findings highlight a breakdown between screening and intervention, suggesting the need for improved protocol adherence and clearer accountability in perioperative nutritional care.
Implications for practice
Improving adherence to nutritional care protocols may help reduce postoperative complications and support better recovery outcomes in older surgical patients.