Most Canadian HCPs agree that perioperative malnutrition is a treatment priority, yet malnutrition screening occurs mostly in the postoperative period and does not always result in a dietitian referral. The main barrier to screening was related to opportunity. Available screening tools are not specific to predict surgical outcomes; there is a need to develop and implement a Nutrition Prehabilitation Screening Tool for surgical patients to target those who will benefit most from nutrition prehabilitation. Considering that the surgical stress response can cause a cascade of reaction leading to loss of muscle mass (and possibly function), there is a need to reevaluate current nutritional standards of care for surgical patients. Prehabilitation combines exercise, nutritional, and psychological interventions administered before surgery to improve patient outcomes. Preoperative sarcopenia, malnutrition, reduced physical fitness, impaired psychological reserves and anxiety in the preoperative period have been identified as markers of poorer outcomes in surgical patients. Multimodal interventions targeting these modifiable risk factors have been associated with improved surgical recovery. Screening and intervening for sarcopenia and frailty allows to identify and provide early, targeted and personalized interventions to improve muscle health on patients with who would benefit the most. This assertive approach to nutrition intervention should be continued throughout the surgical trajectory, after discharge from the hospital and facilitated by an informed transition of care to accelerate recovery, optimize functional capacity and ultimately, the quality of life of patients who have undergone surgery. This symposium will explore the continuum of nutritional care, from surgical screening to recovery.
Dr. Katherine Ford is a Research Associate with the Canadian Nutrition Society and Canadian Malnutrition Task Force. She is supporting the Canadian Malnutrition Taskforce with bridging the transfer of nutrition care from hospital to community. Katherine is also an Adjunct Assistant Professor in the Department of Kinesiology and Health Sciences at the University of Waterloo where her research focuses on integrating a malnutrition care standard in Canadian hospitals and advancing the health policy landscape for malnutrition. Katherine utilizes her experience as Dietitian to bring a clinical perspective to her research and is interested in better understanding the impact of nutritional assessment and interventions on patient-oriented outcomes and how to spread and scale effective interventions focused on improving malnutrition care.