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Incidence and recognition of malnutrition in hospital

Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee DD1 9SY Correspondence to: Mrs McWhirter.

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.

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• POWELL-TUCK, J (2000). Perioperative nutritional support: does it reduce hospital complications or shorten convalescence?. Gut 46: 749-750 [Full text]  
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• FIACCADORI, E., LOMBARDI, M., LEONARDI, S., ROTELLI, C. F., TORTORELLA, G., BORGHETTI, A. (1999). Prevalence and Clinical Outcome Associated with Preexisting Malnutrition in Acute Renal Failure: A Prospective Cohort Study. J. Am. Soc. Nephrol. 10: 581-593 [Abstract] [Full text]  
• Potter, J., Langhorne, P., Roberts, M. (1998). Routine protein energy supplementation in adults: systematic review. BMJ 317: 495-501 [Abstract] [Full text]  
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• (1996). Malnourished inpatients: overlooked and undertreated. DTB 34: 57-60 [Abstract] [Full text]  
• McGlone, P., Dickerson, J.W.T., Davies, G. J. (1995). The feeding of patients in hospital: a review. The Journal of the Royal Society for the Promotion of Health 115: 282-288 [Abstract]  
• Avenell, A, George, L, Miller, S, Miller, J M, Lock, M, Vald, V, Royce, C, Taylor, M, Mackay, G (1994). Starvation in hospital. Refer early to a dietitian.. BMJ 308: 1369-1370 [Full text]  
• Garrow, J (1994). Starvation in hospital. BMJ 308: 934-934 [Full text]