Which patients should be assessed

Obviously, patients with apparently normal physical build, normal diet intake, and no reason for significant increased nutrient requirements need no further investigation. However, the following types of patient require a more precise assessment.

1. Patients presenting with clinical evidence of malnutrition (marasmus or the hypoalbuminemic form of protein energy malnutrition or a mixed form).

2. Patients with chronic diseases such as cancer, alcoholism, liver disease, and kidney disease, particularly those undergoing aggressive treatment, such as chemotherapy, which impairs nutrient absorption and/or utilization.

3. Patients with acute conditions accompanied by high catabolic rates, such as severe sepsis, trauma, and emergency surgery.

4. Geriatric patients: undernutrition is more frequent in older persons because aging is associated with a physiological anorexia, as well as other causes such as poor dentition, economic problems, and chronic illness. Nutrition-mediated complications are more frequent in these patients.

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