How important is malnutrition? A prospective study in internal medicine

Area of Science:

• Clinical Nutrition
• Medical Assessment
• Patient Monitoring

Background:

• Prevalence of malnutrition on hospital admission is variable.
• Limited follow-up data exists for hospitalized patients.
• Assessing nutritional status requires reliable methods.

Purpose of the Study:

• To evaluate the nutritional status of unselected patients upon hospital admission and discharge.
• To compare different assessment methods for nutritional status.
• To identify changes in nutritional status during hospitalization.

Main Methods:

• Nutritional status assessed using Mini Nutritional Assessment (MNA), weight, anthropometry, bioelectrical impedance analysis, and biochemical markers.
• 430 patients assessed on admission; 168 re-assessed after >=6 days hospitalization.
• Physician's subjective clinical assessment was also recorded.

Main Results:

• On admission, 10% of patients were malnourished (MNA), 20% at risk, and 70% adequately nourished. 47% were overweight and 8% underweight.
• Clinical judgment alone missed 4.3% of malnourished patients identified by MNA.
• Malnourished patients (MNA) showed lower BMI, body composition, and certain lab values (hemoglobin, albumin, prealbumin, cholesterol), but higher C-reactive protein.
• During hospitalization (>=6 days), 57% lost weight and 39% gained weight. Only 1.9% were malnourished and lost further weight.

Conclusions:

• A low prevalence (10%) of malnutrition was observed on hospital admission.
• Clinical judgment and anthropometric measurements are useful for assessing nutritional status.
• Laboratory values were found to be less reliable for nutritional status assessment in this cohort.