Screening and prognostic value of malnutrition in the hospital setting.

Many hospitalized patients are malnourished and the relationship between ma lnutrition, and outcome is well established. To determine which patients ar e at nutritional risks clinical scores are probably more accurate than eval uation using a single nutritional parameter. Among the numerous scores publ ished, the Nutrition Risk Index and the Subjective Global Assessment are bo th well validated. One is based on objective measurements, whereas the seco nd is based on medical history and physical examination, Effects of malnutr ition on clinical outcome have been particularly well-demonstrated in surgi cal patients, and it is now recommended to treat malnutrition before surger y. In medical patients malnutrition has also been demonstrated to be predic tive of poor outcome. Moreover it induces an increase of the diagnosis-rela ted group length of stay and hospital charges. To prevent and to treat maln utrition is now essential and nutrition teams are needed in hospitals.