Incidence and recognition of malnutrition in hospital
J P McWhirter,C R Pennington +1 more
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TLDR
Malnutrition remains a largely unrecognised problem in hospital and highlights the need for education on clinical nutrition in different clinical units.Abstract:
Objectives : To determine incidence of malnutrition among patients on admission to hospital, to monitor their changes in nutritional status during stay, and to determine awareness of nutrition in different clinical units. Design : Prospective study of consecutive admissions. Setting : Acute teaching hospital. Subjects : 500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery, and medicine for the elderly. Main outcome measures: Nutritional status of patients on admission and reassessment on discharge, review of case notes for information about nutritional status. Results : On admission, 200 of the 500 patients were undernourished (body mass index less than 20) and 34% were overweight (body mass index >25). The 112 patients reassessed on discharge had mean weight loss of 5.4% with greatest weight loss in those initially most undernourished. But the 10 patients referred for nutritional support showed mean weight gain of 7.9%. Review of case notes revealed that, of the 200 undernourished patients, only 96 had any nutritional information documented. Conclusion : Malnutrition remains a largely unrecognised problem in hospital and highlights the need for education on clinical nutrition.read more
Citations
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ESPEN Guidelines for Nutrition Screening 2002
TL;DR: These guidelines deliberately make reference to the year 2002 in their title to indicate that this version is based on the evidence available until 2002 and that they need to be updated and adapted to current state of knowledge in the future.
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Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials.
TL;DR: The screening system appears to be able to distinguish between trials with a positive effect vs no effect, and it can therefore probably also identify patients who are likely to benefit from nutritional support.
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The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis.
TL;DR: It was concluded that malnutrition, as analyzed by a multivariate logistic regression model, is an independent risk factor impacting on higher complications and increased mortality, length of hospital stay and costs.
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Assessing the Nutritional Status of the Elderly: the Mini Nutritional Assessment as Part of the Geriatric Evaluation
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Prognostic impact of disease-related malnutrition.
TL;DR: This review focuses on the studies investigating the prognostic implications of disease-related malnutrition and concludes that nutritional assessment is mandatory in order to recognise malnutrition early and initiate timely nutritional therapy.
References
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TL;DR: Compared with a similar survey among surgical patients, the medical patients were more depleted calorically but had better protein status (arm-muscle circumference, serum albumin) than the non-medical patients, which is likely to be associated with diminished cell-mediated immunity.
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