Protein depletion and surgical risk.

This study was designed to test the hypothesis that protein depleted surgical patients are at an increased risk of postoperative complications following major surgery; 101 patients and 59 normal volunteers had measurements of nutritional status (weight loss (%), midarm muscle circumference, plasma transferrin and prealbumin concentration and a direct measurement of pre-operative protein depletion, the protein index) and the patient's postoperative course was carefully monitored from the time of operation until discharge. The patients were divided into two categories on the basis of the extent of protein depletion: non-protein depleted patients (4% mean protein loss) and protein depleted patients (39% mean protein loss). The protein depleted patients had a significantly higher incidence of major complications, pneumonia and stayed in hospital longer (both overall stay and postoperatively).