Does MUST scoring identify sarcopenic emergency surgery patients?
Research type
Research Study
Full title
Are older emergency abdominal surgical patients identified as being at risk of malnutrition and sarcopenia – a retrospective observational study?
IRAS ID
315086
Contact name
Dermot Burke
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
0 years, 3 months, 8 days
Research summary
In the UK, the Malnutrition Universal Scoring Tool (MUST) is utilised to assess the risk of the presence of malnutrition in patients (NICE 2017) and once identified as being either medium or high risk for potential malnutrition, the resulting score should trigger intervention with nutritional support either with nutritional supplementation and /or referral to specialist dietetic referral. MUST is a quick bedside assessment containing 5 steps using measurements of a patient’s height, weight, illness severity assessment and recent dietary input records, to identify the presence of malnourishment. The use of MUST in identifying malnutrition in older patients has been previously validated by NICE (2017) but NICE (2017) also recommended further study to validate the tool as identifying patients at risk of malnutrition. The European Society for Clinical Nutrition and Metabolism (ESPEN) practical guideline covering clinical nutrition in surgery, suggest that perioperative nutrition is indicated in patients with malnutrition and those at risk of malnutrition. Malnutrition is associated with decreased muscle mass, quality and function, a physiological process known as sarcopenia.
The presence of age-related sarcopenia amongst older patients presenting for emergency intervention who are at risk of malnourishment has the potential to provide an important biomarker in the risk assessment process for decisions about treatment options. A radiological assessment of sarcopenia using the patient's preoperative CT scan, conducted as part of their usual pre-operative care, affords the opportunity to clarify the extent of the presence of pre-existing sarcopenia which may have a detrimental effect to the patient’s postoperative recovery. Identification radiologically of sarcopenia in older emergency surgical patients as been associated with an increased 30-day mortality.
The study will explore whether the use of MUST risk recording identifies emergency laparotomy patients who are malnourished and sarcopenic at presentation for surgery.
REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
23/YH/0227
Date of REC Opinion
21 Dec 2023
REC opinion
Further Information Favourable Opinion