Abstract
Several methods have been propsed to assess nutritional status of patients in relation to post-operative complications including instant nutritional assessment (INA) and prognostic nutritional index (PNI). Weight loss (WL) has also been related to post-operative morbidity. A prospective study was conducted to evaluate the prognostic ability of INA, PNI and WL in 300 patients affected by major and semi-major surgeries. Post-operative sepsis occurred in 28 (9.3%) patients. Of the 300 patients studied, 91 (30.2%) had WL ⩾ 10%; 12 patients were septic. Of the 28 septic patients indentified, 24 (85.7%) were within the high-risk group as identified by PNI characterisation. When both serum albumin and total lymphocyte count were abnormal, sepsis rate was 100%. All methods had a Youden index greater than one. Therefore, WL should be the first parameter assessed, and if WL is > 10%, then INA can be used to assess the patient further.