Mudarra-García Natalia, Roque-Rojas Fernando, Nieto-Ramos Almudena, Izquierdo-Izquierdo Visitación, García-Sánchez Francisco Javier
Research Nursing Area, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain.
Nursing Department, Faculty of Nurse, Phisiotherapy and Podology, University Complutense of Madrid, 28040 Madrid, Spain.
Nutrients. 2025 Apr 29;17(9):1509. doi: 10.3390/nu17091509.
Surgical patients often experience nutritional imbalances due to their underlying condition and the forthcoming surgical procedure. These imbalances can increase the risk of post-operative complications. To mitigate such risks, a comprehensive nutritional assessment-also known as morphofunctional assessment-should be conducted. This includes evaluating body composition (muscle and fat mass), muscle strength, and functional capacity. We conducted an observational, prospective, pre-post interventional study involving 138 patients undergoing major elective surgery. Each patient received a morphofunctional assessment and an individualized prehabilitation program, including nutritional supplementation, physical exercise, and comorbidity optimization for 21 days before surgery and one month afterward. Outcomes were assessed through bioimpedance (muscle mass), muscle ultrasound (QRF thickness), dynamometry (strength), and visceral fat ultrasound (fat reduction). The patient's morphofunctional assessment and subsequent nutritional and physical exercise optimization performed during the month before surgery in the prehabilitation consultation led to an increase in muscle mass (measured by bioimpedance analysis, = 0.001), and muscle ultrasound, (QRF thickness: < 0.001) and dinamometry (muscle strength: = 0.014); a reduction in preperitoneal visceral fat thickness (reduction < 0.001); and an improvement in the patients' nutritional status, with a decrease in malnutrition rates (64.8% vs. 31.8%). As a result, post-operative complications were effectively prevented ( < 0.001). Pre-operative patient optimization by means of a prehabilitation program led to increased muscle strength, improved muscle mass, reduced complication rates, and shorter hospital stays. In addition, patients maintained their quality of life and functional capacity following surgery.
外科手术患者常常因其基础疾病和即将进行的手术而出现营养失衡。这些失衡会增加术后并发症的风险。为降低此类风险，应进行全面的营养评估，也称为形态功能评估。这包括评估身体成分（肌肉和脂肪量）、肌肉力量和功能能力。我们开展了一项观察性、前瞻性、术前术后干预研究，涉及138例接受大型择期手术的患者。每位患者在手术前21天及术后1个月都接受了形态功能评估和个性化的术前康复计划，包括营养补充、体育锻炼和合并症优化。通过生物电阻抗（肌肉量）、肌肉超声（股直肌厚度）、握力测量（力量）和内脏脂肪超声（脂肪减少）来评估结果。术前康复咨询期间在手术前一个月进行的患者形态功能评估以及随后的营养和体育锻炼优化导致肌肉量增加（通过生物电阻抗分析测量，P = 0.001）、肌肉超声（股直肌厚度：P < 0.001）和握力测量（肌肉力量：P = 0.014）；腹膜前内脏脂肪厚度减少（减少P < 0.001）；患者营养状况得到改善，营养不良率降低（64.8%对31.8%）。结果，有效预防了术后并发症（P < 0.001）。通过术前康复计划对术前患者进行优化可提高肌肉力量、改善肌肉量、降低并发症发生率并缩短住院时间。此外，患者在术后保持了生活质量和功能能力。
