The evaluation of nutritional status in general medical patients

Abstract

We have analised the nutritional status of 415 hospitalised patients in an internal medicine service; 240 were males and 175 females; mean age was 56.6 ± 1.1 and 59.2 ± 1.5 years respectively. In these patients weight for height, triceps skinfold, arm muscle circumference, temporal muscle atrophy, Bichat's fat atrophy and serum albumin concentration were investigated. We have considered that a patient was malnourished when three or more of the six criteria mentioned above were affected. The prevalence of undernutrition was 40% (43.2% of the males and 35.2% of the females). We found more undernutrition in the males than in the females (weight for height less than 90% in 32.8% and 16.5% respectively). The prevalence of obesity (weight for height more than 120), was 18%, higher in the females (11.6%) of the males and 27% of the females). Aging was related to poor nutritional status, less caloric and protein intake, loss of the Bichat's fat, temporal muscle atrophy, and lower serum albumin. Smoking and drinking were also associated with a worse nutritional status. Patients with temporal muscle atrophy or Bichat's fat atrophy had a smaller intake of protein and calories, smaller values of the anthropometric parameters (WH, TS, AMC) and lower Hb and serum albumin levels. The relationships suggest that these two ‘simple’ clinical parameters are useful in the assessement of undernutrition.