Nutritional status on admission to a general surgical ward in a Sydney hospital

To assess the nutritional status of patients on admission to a general surgical ward in a major teaching hospital in Sydney, we examined 84 men and women. We measured, recorded, and/or calculated: history of weight loss, body mass index (BMI), triceps skinfold, arm muscle circumference, hemoglobin, total lymphocyte count, and plasma albumin level. Measurements were graded normal, borderline, or abnormal and patients were considered malnourished if they had two or more abnormal measurements, three or more borderline measurements, or one abnormal and two borderline measurements. Thirty-one patients (37%) were found to have one or more measurements below the reference range. Twelve patients (14%) were considered malnourished and of this group more than half were of normal weight or overweight. But if indices of overnutrition are included in a definition of malnutrition then a high BMI was the most common abnormal index of nutritional status. Forty-six patients (55%) had a BMI of greater than 25, that is, were overweight. This single study showed a higher percentage of overnutrition amongst hospital patients than previous work has indicated and secondly that malnourished patients are not necessarily underweight.