title: Still hungry in hospital: identifying malnutrition in acute hospital admissions.
abstract: We assessed the prevalence, methods for recognition and clinical management of malnutrition in acute admissions in a large academic inner-city hospital. Of a total of 337 patients, it was possible to measure both height and weight in 219 patients (65% of admissions). As an alternative for bed-bound patients, mid-upper arm circumference was not very reliable in predicting BMI (sensitivity 98%; specificity 65%), and waist circumference even less so. Of these, 13% were malnourished (body mass index BMI <18.5 kg/m(2) or BMI 18.5-20 kg/m(2) with reported weight loss >3 kg in the last 3 months). Six patients (31% of those with BMI <18.5 kg/m(2)) and one with BMI 18.5-20 kg/m(2) were recognized as suffering from malnutrition and referred to the dietitian. Review of case records could not establish if the diagnosis was missed in the remainder, or if a conscious decision was taken not to manage malnutrition actively. Malnutrition in acute hospital admissions goes apparently unrecognized and unmanaged in 70% of cases. Since there are serious consequences, and effective simple treatment is readily available, increased awareness is required, with routine assessment of nutritional status in all patients.
authors.affiliation: Department of Human Nutrition, University of Glasgow, Royal Infirmary, Glasgow, UK.
authors.forename: I E
authors.initials: IE
authors.lastname: Kelly
authors.forename: S
authors.initials: S
authors.lastname: Tessier
authors.forename: A
authors.initials: A
authors.lastname: Cahill
authors.forename: S E
authors.initials: SE
authors.lastname: Morris
authors.forename: A
authors.initials: A
authors.lastname: Crumley
authors.forename: D
authors.initials: D
authors.lastname: McLaughlin
authors.forename: R F
authors.initials: RF
authors.lastname: McKee
authors.forename: M E
authors.initials: ME
authors.lastname: Lean
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D004630:Emergencies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D006815:Hunger; D008297:Male; D008875:Middle Aged; D009748:Nutrition Disorders / Q000453:epidemiology* / Q000628:therapy; D015995:Prevalence; D012017:Referral and Consultation; D012606:Scotland / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data