Still hungry in hospital: identifying malnutrition in acute hospital admissions

We assessed the prevalence, methods for recognition and clinical management of malnutrition in acute admissions in a large academic inner-city hospita l. Of a total of 337 patients, it was possible to measure both height and w eight in 219 patients (65% of admissions). As an alternative for bed-bound patients, mid-upper arm circumference was not very reliable in predicting B MI (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 di etitian. Review of case records could not establish if the diagnosis was mi ssed in the remainder, or if a conscious decision was taken not to manage m alnutrition actively. Malnutrition in acute hospital admissions goes appare ntly unrecognized and unmanaged in 70% of cases. Since there are serious co nsequences, and effective simple treatment is readily available, increased awareness is required, with routine assessment of nutritional status in all patients.