Incidence and recognition of malnutrition in hospital

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.

[1]  G. Hill,et al.  Risk Factors for Postoperative Pneumonia: The Importance of Protein Depletion , 1988, Annals of surgery.

[2]  S. Heymsfield,et al.  Cardiac abnormalities in cachectic patients before and during nutritional repletion. , 1978, American heart journal.

[3]  M. Taylor,et al.  Hand grip dynamometry as a predictor of postoperative complications reappraisal using age standardized grip strengths. , 1989, JPEN. Journal of parenteral and enteral nutrition.

[4]  S. Eskenazi.  Impact of nutritional status on DRG length of stay. , 1987, JPEN. Journal of parenteral and enteral nutrition.

[5]  G. A. Young,et al.  MALNUTRITION IN SURGICAL PATIENTS An Unrecognised Problem , 1977, The Lancet.

[6]  M. Kaminski,et al.  Increasing malnutrition during hospitalization: documentation by a nutritional screening program. , 1985, Journal of the American College of Nutrition.

[7]  G. Blackburn,et al.  Protein status of general surgical patients. , 1974, JAMA.

[8]  M. Wiseman,et al.  The dietary and nutritional survey of British adults. , 1990 .

[9]  M. Burr,et al.  Anthropometric norms in the elderly , 1984, British Journal of Nutrition.

[10]  D. F. Rochester,et al.  Respiratory muscle strength and maximal voluntary ventilation in undernourished patients. , 2015, The American review of respiratory disease.

[11]  G. Blackburn,et al.  Prevalence of malnutrition in general medical patients. , 1976, JAMA.

[12]  D. bryce,et al.  CRAFT: an aid to medical audit, research and patient management. , 1988, Health bulletin.

[13]  Lawrence A Leiter.  Treat obesity seriously, J.S. Garrow. Churchill Livingstone, Edinburgh (1981), 246, £11·00 , 1984 .

[14]  J. Reilly,et al.  Economic impact of malnutrition: a model system for hospitalized patients. , 1988, JPEN. Journal of parenteral and enteral nutrition.

[15]  P. Bowen,et al.  Norms for nutritional assessment of American adults by upper arm anthropometry. , 1981, The American journal of clinical nutrition.

[16]  Josef Brozek,et al.  The Biology of Human Starvation. , 1950 .