Hospital malnutrition. A prospective evaluation of general medical patients during the course of hospitalization

Nutrition status was evaluated in 134 consecutive admissions to a general medical service and throughout hospitalization among patients hospitalized 2 weeks or longer. Likelihood of malnutrition was determined using eight nutrition-related parameters: serum folate and vitamin C, triceps skinfold, weight/height, arm muscle circumference, lymphocyte count, serum albumin, and hematocrit. On admission 48% of patients had a high likelihood of malnutrition, which correlated with a longer hospital stay (20 versus 12 days for patients with a low likelihood of malnutrition) and an increased mortality rate (13 versus 4%). Likelihood of malnutrition increased with hospitalization in 69% of patients with paired determinations. Compared to admission, at final follow-up a greater proportion of patients fell into the depleted range of values for folate, triceps skinfold, weight/height, arm muscle circumference, lymphocyte count, and hematocrit. These parameters worsened in over 75% of patients admitted with normal values. Hematocrit fell in all patients with normal admission levels. These findings demonstrate and association between nutrition status and hospital course and a worsening trend during hospitalization.