Introduction Malnourished Surgical patients are at a significantly greater risk of post-operative complications and death than well-nourished patients. The “Malnutrition Universal Screening Tool” (MUST) is a validated tool for identifying at-risk patients. This paper studies the application of MUST in patients undergoing emergency abdominal surgery and the accuracy of this tool in predicting need for artificial nutritional support and clinical outcome.
Methods A prospective cohort study of patients undergoing emergency abdominal surgery at a university surgical unit over a 2-month period was undertaken. MUST data were collected prospectively and admission and highest (maximum score during admission) MUST scores calculated independently by two researchers. Clinical outcome data were collected.
Results 55 patients were included, median age 66. Median admission and highest MUST scores were 0. Eighteen patients had a highest MUST of ≥2. Post-operative complications included ileus (n=9), severe sepsis (n=6) and death (n=10), and were associated with increased highest MUST scores (2 vs 0, p=0.005). All patients with MUST ≥4 died (n=4). On multivariate analysis, both admission and highest MUST scores predicted need for artificial nutritional support (p=0.011 and p=0.005). A highest MUST score ≥4 independently predicted both artificial nutritional support requirement (p<0.001) and death (p<0.001).
Conclusion Admission MUST scores predict requirement for artificial nutritional support. MUST scores repeated during admission offer utility in predicting both requirement for artificial nutritional support and survival. Clinicians have a responsibility to ensure accurate nutritional assessments are undertaken throughout hospital admission in order to identify those at risk and institute appropriate treatment.
Competing interests None declared.
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