8 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M a r c h 2 0 1 7
recognizing malnutrition
in patients has long been a
challenge. I helped devel-
op a simple scoring sys-
tem to assess a patient's
pre-op nutritional status:
The Perioperative
Nutrition Score (PONS),
which you can use to
assess the presence of
nutrition risk based on a
patient's body mass index (BMI), recent changes in weight, and a
recent decrease in dietary intake and pre-op albumin level, which
is a measure of blood plasma proteins. These 3 questions deter-
mine the PONS:
1. Is the patient's BMI less than 18.5 (or less than 20 for those
65 years or older)?
2. has the patient experienced unplanned weight loss of more
than 10% of their body weight in the past 6 months or 5% of
their body weight in the month before surgery?
3. has the patient been eating less than half of what they would
normally consume over the previous 5 days?
Patients who answer "yes" to any of the 3 questions or have an
albumin level of less than 3.0 g/dL are malnourished and at major
risk of suffering post-op complications.
— Paul Wischmeyer, MD, EDIC
PRE-OP ASSESSMENT
Ask 3 Questions to ID Malnourished Patients
• DIET PLAN As more complex cases move to the outpatient arena, it is
increasingly important to assess the nutritional status of ambulatory patients.
Paul
Wischmeyer,
MD,
EDIC
