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Perioperative Nutrition Screen (PONS)

Screens surgical patients for nutritional risk using four routinely available criteria.

Perioperative Nutrition Screen (PONS)
Age
years
Body mass index (BMI)
kg/m^2
Unintentional weight loss >10% in the past 6 months
Eating less than 50% of usual diet in the past week
Serum albumin (if available)
Complete the fields above to see the result.

When to use

  • Rapidly screening surgical patients preoperatively for nutritional risk to trigger a full dietitian assessment.

Formula

1 point for each positive criterion: BMI <18.5 (age <=65) or <20 (age >65); weight loss >10% in 6 months; oral intake <50% of usual in the past week; albumin <3.0 g/dL (if available, and without hepatic/renal dysfunction as the sole cause). Any positive criterion = at risk.

Pearls and pitfalls

  • Adapted from the Malnutrition Universal Screening Tool (MUST) for the preoperative setting.
  • Albumin is optional - the screen can be completed with the first three criteria alone if albumin is not available.

References

  1. Wischmeyer PE, Carli F, Evans DC, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on nutrition screening and therapy within a surgical enhanced recovery pathway. Anesth Analg. 2018;126(6):1883-1895.