Incidence and recognition of malnutrition in hospital J. P. McWhirter and C. R. Pennington BMJ 1994; 308: 945-948

This paper describes a prospective study to determine the incidence of malnutrition among patients on admission to an acute teaching hospital, to monitor their changes in nutritional status during stay and to determine awareness of nutrition in different clinical units. Nutritional status was assessed in 500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery and medicine for the elderly. The main outcome measures were weight, height, triceps skinfold thickness, mid arm circumference, mid arm muscle circumference and grip strength. Patients were studied on admission and discharge and case notes reviewed for information about nutritional status. On admission 200 out of 500 patients were considered undernourished (BMI < 20). Of these only 96 had any nutritional information documented in the notes. 34% of patients were overweight (BMI > 25). The 112 patients reassessed on discharge had a mean weight loss of 5.4% with the greatest weight loss in those initially most malnourished. The 10 patients who were referred for nutritional support (3 for parenteral nutrition, 7 for enteral nutrition) showed a mean weight gain of 7.9%.