Why assess nutritional status

Nutrition and disease interact in several ways. One or combinations of at least two of the following processes are almost always present in critically ill patients: decreased nutrient intake, increased body requirements, and altered nutrient utilization. The frequency of malnutrition in hospital in-patients has been estimated to be between 30 and 50 per cent of both medical and surgical patients. There is an established relationship between initial nutritional status and in-hospital morbidity and mortality. Many complications are related to protein energy malnutrition: increased nosocomial infection rates due to diminished immune competence, delayed wound healing due to decreased ability to repair tissue, delayed weaning from mechanical ventilation due to altered vital functions, and frequent depression and psychological disturbances. Patients with protein energy malnutrition have two- to fourfold higher mortality. Moreover, adequate nutritional support has been shown to improve outcome and reduce the duration of hospital stay in different subsets of malnourished patients.

Therefore assessing nutritional status pursues several goals: determination of nutritional deficiencies and evaluation of risk factors of nutrition-related complications that could affect the outcome of the patient; evaluation of the need and potential value of nutritional support; monitoring the efficacy of nutritional support and therapeutic response.

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