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Incidence and recognition of malnutrition in hospital
J P McWhirter1, C R Pennington
1Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee.
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.