RT Book, Section
A1 Jensen, Gordon L.
A2 Loscalzo, Joseph
A2 Fauci, Anthony
A2 Kasper, Dennis
A2 Hauser, Stephen
A2 Longo, Dan
A2 Jameson, J. Larry
SR Print(0)
ID 1190492523
T1 Malnutrition and Nutritional Assessment
T2 Harrison's Principles of Internal Medicine, 21e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264268504
LK accessmedicine.mhmedical.com/content.aspx?aid=1190492523
RD 2024/04/19
AB Malnutrition  occurs  in  30–50%  of  hospitalized  patients  depending  on  the  setting  and  criteria  that  are  used.  Poor  wound  healing,  compromised  immune  status,  impaired  organ  function,  increased  length  of  hospital  stay,  and  increased  mortality  are  among  the  notable  adverse  outcomes  associated  with  malnutrition.  It  is  now  widely  appreciated  that  acute  or  chronic  inflammation  contribute  to  the  pathophysiology  of  disease-related  or  injury-related  malnutrition.  The  presence  of  inflammation  can  also  render  historic  nutrition  assessment  indicators,  like  albumin  and  prealbumin,  unreliable,  and  inflammation  diminishes  favorable  responses  to  nutrition  therapies.  In  order  to  guide  appropriate  care,  it  is  necessary  to  properly  assess  and  diagnose  malnutrition.  Nutrition  assessment  is  a  comprehensive  evaluation  to  diagnose  a  malnutrition  syndrome  and  to  guide  intervention  and  expected  outcomes.  Patients  are  often  targeted  for  assessment  after  being  identified  at  nutritional  risk  based  on  screening  procedures  conducted  by  nursing  or  nutrition  personnel  within  24  h  of  hospital  admission.  Screening  tends  to  focus  explicitly  on  a  few  risk  variables  like  weight  loss,  compromised  dietary  intake,  and  high-risk  medical/surgical  diagnoses.  Preferably,  health  professionals  complement  this  screening  with  a  systematic  approach  to  comprehensive  nutrition  assessment  that  incorporates  an  appreciation  for  the  contributions  of  inflammation  that  serve  as  the  basis  for  new  approaches  to  the  diagnosis  and  management  of  malnutrition  syndromes.