The Importance of Hydration and Nutritional Support

Frail people are at increased risk of malnutrition and dehydration. The surgery itself exposes to a catabolic state with a consequent muscle wasting. A preoperative comprehensive assessment of the nutritional status and the grade of hydration is fundamental in order to prevent postoperative complications (geriatric syndromes such as delirium, dehiscence, and relapses). Preoperative nutritional status could be screened with simple and effective methods like MUST (Malnutrition Universal Screening Tool), MNA-SF (Mini Nutritional Assessment-Short Form), or GNRI (Geriatric Nutritional Risk Index). Hydration could be evaluated with serum osmolarity better than by clinical methods. A multidisciplinary approach to elderly people approaching surgery is seminal to planning a specific pathway of preoperative nutritional and hydration support. The use of carbohydrates, especially proteins and/or aminoamides must be encouraged to counterbalance the potential effects of surgery in elderly people.