title: Three simple methods of detecting malnutrition on medical wards.
abstract: Malnutrition in hospital is often unrecognized. A nutrition team aims to teach simple methods of detecting malnutrition. On a single day all medical in-patients underwent a nutritional assessment. Eighty-four patients (43 men), median age 71 years (range 28-97), were assessed. The most common diagnoses were cardiac disease (26), stroke/dementia (12), non-malignant lung disease (9) and malignancy (6). A weight loss of more than 10% (%WL) was found in 17/65 (26%) and a body mass index (BMI) of less than 19 kg/m2 in 13/69 (19%). A mid-arm muscle circumference (MAMC) less than the fifth percentile occurred in 16/83 (19%) patients. Percentage weight loss alone detected seven patients of whom four were overweight (BMI > 25 kg/m2), BMI alone detected three patients, and MAMC alone eight patients of whom three could not be weighed and three had fluid retention. There was fluid retention in 35/84 (42%) patients of whom nine were malnourished (six detected by BMI and/or %WL, and three by MAMC alone). All three measurements were made in 64 patients, six (9%) of whom were detected as malnourished by all three methods. Combining the three measurements 29/84 (35%) of patients were malnourished and only 28% of these patients had been assessed by a dietitian. BMI and %WL detect most patients but fluid retention may limit their accuracy. MAMC is useful in those who cannot be weighed or who have fluid retention.
authors.affiliation: Leicester General Hospital NHS Trust, England.
authors.forename: J M
authors.initials: JM
authors.lastname: Nightingale
authors.forename: N
authors.initials: N
authors.lastname: Walsh
authors.forename: M E
authors.initials: ME
authors.lastname: Bullock
authors.forename: A C
authors.initials: AC
authors.lastname: Wicks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000473:pathology; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D004487:Edema / Q000150:complications; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000175:diagnosis* / Q000473:pathology; D009752:Nutritional Status; D015431:Weight Loss