How important is malnutrition? A prospective study in internal medicine.
OBJECTIVE
Data about the prevalence of malnutrition on hospital admission vary and follow-up data are scarce. We assessed the nutritional status of unselected patients on admission and discharge.


METHODS
A total of 430 consecutively admitted patients were assessed and 168 patients hospitalized > or =6 days were reassessed on discharge. Assessment was carried out by the Mini Nutritional Assessment (MNA), weight and anthropometric measurements, bioelectrical impedance analysis, biochemical markers and a subjective clinical assessment by the physicians in charge.


RESULTS
On admission, 47% of all patients were overweight (body mass index, BMI >25 kg m(-2)) and 8% underweight (BMI<18.5 kg m(-2)). In terms of the MNA 70% were adequately nourished, 20% were at risk for malnutrition and 10% were malnourished. By clinical judgment alone 18 (4.3%) malnourished patients according to MNA were missed. The 44 malnourished patients according to the MNA had significantly lower values for BMI, fat-free mass, fat mass, waist circumference, triceps skinfold thickness, hemoglobin, albumin, prealbumin, total cholesterol but higher values for C-reactive protein. Of the 168 patients staying > or =6 days in hospital, 57% lost and 39% gained weight. Only 1.9% of all patients (8 of 430) were malnourished and lost further weight during hospitalization.


CONCLUSIONS
We found a low prevalence (10%) of malnourished patients on admission. Clinical judgment and to some extent anthropometrical measurement were helpful for assessing the nutritional status, laboratory values were not.
Venzin
R M
RM
Department of Internal Medicine, Kantonsspital Graubünden, Chur, Switzerland.
Kamber
N
N
Keller
W C F
WC
Suter
P M
PM
Reinhart
W H
WH
D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000032:analysis; D001823:Body Composition; D049628:Body Size; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D013557:Switzerland; D013851:Thinness / Q000453:epidemiology; D015430:Weight Gain; D015431:Weight Loss
D000418:Albumins; D006454:Hemoglobins; D002097:C-Reactive Protein; D002784:Cholesterol