c 00

SGA (subjective Subjective assessment (22) Square shoulders global assessment) Limbs evidence of muscle and fat loss Loss of fat pads under eyes Denting of temples Laboratory Serum albumin < 30 g/1


Clinical condition

Socio-economic status



Total lymphocyte count

Glycaemic control Laboratory/ward glucose testing

Organ failure Cancer


Socially isolated Dementia

Very subjective. Not sensitive at monitoring changes in nutritional status. Useful to use in conjunction with objective parameters

Underlying disease is the usual cause of a low albumin. Nutritional support usually required when CRP high and albumin low. Use pre- not post-up albumin for assessment. Check human albumin solution is not being administered

Very low levels can indicate malnutrition or overhydration. Interpret in conjunction with creatinine

Below normal range may indicate decreased muscle bulk

< 1200 mm3 Likely to reflect disease state rather than nutri-

(= % lymphocytes xWBC/100) tional status. Sensitivity and specificity low

Fasting pi. glucose > 8 mmol/1

2 h post-prandial > 12 mmol/1

Elderly Renal

Except breast Housing

Housebound, less than one visitor per week High alcohol intake

Poor glycaemic control increases energy expenditure, adversely affecting weight, muscle bulk, wound healing and immune function (23). Causes pseudo-hyponatraemia. For every 0.34mmol/1 rise in glucose, sodium falls 1 mmol/1

patients. Special consideration needs to be given to the following circumstances.

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