Nutrition screening: time to address the skeletons in the bedroom closet as well as those in hospitals
Ever since Dr Charles Butterworth's seminal article in 19741 on the widespread prevalence of malnutrition in hospitalised patients and its detrimental effect on recovery, attempts have been made to improve the detection of malnutrition through screening initiatives. However, despite compelling evidence that those who are either malnourished at admission or become malnourished during their hospital stay experience increased surgical complications, greater morbidity and increased length of hospital stay2,3 as well as higher rates of mortality at 12 months,4,5 malnutrition often remains undetected and untreated because it is not considered to be a clinical priority. Even overt signs of malnutrition are often missed in medical wards. A French study identified that 12% of patients admitted to an acute geriatric ward over a 1-year period had clinical symptoms of scurvy.6 Of particular concern was that half of those with scurvy had been referred from another acute medical department in which the diagnosis had gone unnoticed. The failure to recognise patients who are at risk of malnutrition and subsequent implementation of timely nutritional intervention often results in a downward spiral whereby patents are discharged back to the community or to a higher level of care, later to be readmitted in a more compromised nutritional state.
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Charlton, K. E. (2010). Nutrition screening: time to address the skeletons in the bedroom closet as well as those in hospitals. Nutrition and Dietetics, 67 (4), 209-212.