Nutrition assessment

Research in nutrition assessment continues to develop. Early research in assessing for the presence of malnutrition resulted in tools and markers being developed for surveying large populations over a short period of time. Many of these tools and markers were then brought to the hospitalized setting and used on individual patients. Jones et al. reported on 44 separate tools published in the past 25 years for determining nutritional status [10]. Most of the perceived traditional markers of protein-calorie malnutrition, such as serum albumin, have such poor sensitivity and large variance that their use on individual patients is of limited value.

A traditional nutrition assessment will often include a dietary, medical and body weight history. Measurements of current body weight and height are recorded. Serum proteins levels, body anthropometrics measurements, immune competence efficacy and functional measurements of muscle strength may be incorporated into the overall final assessment. Individually these measurements often have limited value in accurately determining a patient's nutrition risk. For example, dietary history as recalled by patients can be overestimated by an average of 22% [11]. Most physicians and nurses rely upon a patient's recall of their own weight, rather than a direct measurement, a very unreliable practice [12].

Studies have consistently revealed the inadequacy of any single assessment method or tool to assess a patient's nutritional state. As a result, combinations of diverse measurements have been developed into "scoring systems" designed to increase our sensitivity and specificity in determining nutritional status [13]. In general, global approaches to nutrition assessment of the hospitalized patient can provide a much more definitive picture of a patient's true nutrition risk.

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