RAPPORTS DES EXPERTS
In spite of its simplicity, this index seems to be accurate enough to identify patients for whom a perioperative nutritional support is of benefit.
Due
to the lack of reliability of nutritional indices, the use of a subjective dinical global nutritional assessment has been advocated. It results in the allocation of the patient into one of the three following classes : normal nutritional status, minor denutrition, major denutrition. It can be satisfactorily reproduced by different observers and correlates well with Buzn¥'s NRI. This simple evaluation allows to identify patients for whom a perioperative nutritional support could be beneficial. It is concluded that the two most reliable techniques are the NRI and the subjective global assessment. As a prognostic index for postoperative outcome and a decisional help for the indication of postoperative nutritional support, the classification by MAC CLAVE, which considers the physiopathology of denutrition can be recommended. Finally in future studies, the body mass composition should be assessed with bioelectrical impedance.