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Apparent low frequency of undernutrition in Dublin hospital in-patients: should we review the anthropometric thresholds for clinical practice?

Published online by Cambridge University Press:  09 March 2007

Clare A. Corish ,
P. Flood ,
S. Mulligan  and
N. P. Kennedy
Clare A. Corish*
Affiliation:
Unit of Nutrition and Dietetic Studies, Department of Clinical Medicine, Trinity Centre for Health Sciences, James's St, Dublin 8, Republic of Ireland
P. Flood
Affiliation:
Unit of Nutrition and Dietetic Studies, Department of Clinical Medicine, Trinity Centre for Health Sciences, James's St, Dublin 8, Republic of Ireland
S. Mulligan
Affiliation:
Unit of Nutrition and Dietetic Studies, Department of Clinical Medicine, Trinity Centre for Health Sciences, James's St, Dublin 8, Republic of Ireland
N. P. Kennedy
Affiliation:
Unit of Nutrition and Dietetic Studies, Department of Clinical Medicine, Trinity Centre for Health Sciences, James's St, Dublin 8, Republic of Ireland
*
*Corresponding author: Mrs C. Corish, fax +353 1 454 2043, email [email protected]
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Abstract

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Protein–energy undernutrition, or the possibility of its development, has been documented to occur frequently in patients on admission to hospital. Deterioration in nutritional status is known to occur in hospital. In a prospective study of 594 sequential hospital admissions, we aimed to assess the prevalence of undernutrition among patients on admission to two acute teaching hospitals in Dublin, Republic of Ireland using the widely-accepted anthropometric criteria applied in a large study from Dundee, Scotland, UK () and to determine changes in nutritional status in hospital. The mean prevalence of undernutrition (11 %) was considerably lower than was reported from Dundee (40 %). Unintentional weight loss before admission and functional impairment on admission occurred to a similar extent in both centres. Weight loss in hospital occurred in the same proportion of patients, but less frequently among those undernourished on admission to hospital, in Dublin compared with Dundee. The patients found to be undernourished on admission in this study had a mortality rate in hospital (6·5 %) over three times that of the adequately nourished group (2 %). The magnitude of the difference in prevalence of undernutrition between the two centres cannot be explained by ethnicity, case-mix or age distribution. With the secular increase in BMI in the population, the thresholds for classifying patients as undernourished or at risk of nutritional deterioration may need to be reviewed. For clinical use, recent weight loss and functional status may be more appropriate variables to use in the evaluation of nutritional status on admission to hospital.

Keywords

UndernutritionAnthropometryReference data
Type
Research Article
Information
British Journal of Nutrition , Volume 84 , Issue 3 , September 2000 , pp. 325 - 335
Copyright
Copyright © The Nutrition Society 2000

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