Feasibility of a Pre-Operative Morphofunctional Assessment and the Effect of an Intervention Program with oral Nutritional Supplements and Physical Exercise

Background: Surgical patients tend to experience nutritional imbalances due to the underlying condition that requires their admission and subsequent surgical procedure, which can lead to postoperative complications. To prevent these complications, a comprehensive nutritional assessment should be performed, including a detailed analysis of body composition (muscle mass and fat mass). Based on this assessment, all patients identified as nutritionally at risk or malnourished should receive pre-operative nutritional treatment for a minimum of seven to ten days before surgery. Methods: An observational, descriptive, and comparative (before-after) study was conducted, including a total of 138 patients who underwent morphofunctional assessment and optimization through individualized dietary and exercise guidelines, nutritional supplementation, and correction of comorbidities 21 days before surgery. These same protocols were followed for one month postoperatively. Body composition and functional level were reassessed the day before surgery and one month after the procedure. Results: 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, (p=0.001), and muscle ultrasound, (p< 0.001) and muscle strength (p=0.014); a reduction in preperitoneal visceral fat thickness (p< 0.001); and an improvement in the patients’ nutritional status, with a decrease in malnutrition rates (64.8% vs. 31.8%). As a result, postoperative complications were effectively prevented (p< 0.001). Conclusions: 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.