Nutritional and metabolic assessment of the hospitalized patient

Blackburn, George L.; Bistrian, Bruce R.; Maini, Baltej S.; Schlamm, Haran T.; Smith, Michael F.

doi:10.1177/014860717700100101

Cited by 1,123 publications

(385 citation statements)

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“…Given that the mean hospitalisation length was 10 days, values of weight decline reaching 1% were regarded as significant and those exceeding 2% as dangerous (Blackburn et al, 1977).…”

Section: Discussionmentioning

confidence: 99%

“…In malnutrition, the lymphocyte count in peripheral blood is reduced. It was accepted, according to Blackburn et al (1977), that values between 900 and 1500 cells per mm 3 (0.9-1.5 Â 10 3 /mm 3 ) may point to moderately severe undernutrition, whereas the values o900/mm 3 (0.9 Â 10 3 /mm 3 ) indicate severe undernutrition. However, lymphocyte count depends on many factors such as septic conditions, stress, administration of adrenal steroids and coexistent infections.…”

Section: Discussionmentioning

confidence: 99%

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Nutritional status of patients hospitalised in Poland

et al. 2005

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Aim: Screening and extended assessment of the nutritional status of patients on admission and on discharge from hospital were carried out. Description: The studies were carried out in four teaching hospitals, four provincial hospitals and four county hospitals in Poland. Subjects: Screening examinations were carried out for 3310 randomly selected patients (every 10th patient admitted to hospital, including 1916 female cases aged from 16 to 92 y and 1394 male patients aged from 16 to 100 y). Extended examinations were carried out on 210 patients aged from 16 to 87 y (including 122 female and 88 male). Main assessment parameters: Anthropometric (height, weight, body mass index (BMI), waist-to-hip ratio (WHR), arm circumference) and biochemical indices (erythrocyte count, haemoglobin concentration, white blood cell count, blood lymphocyte count and serum albumin serum concentration). The extended examinations included determination of antioxidant vitamins (A, C, E), vitamin B 12 and folic acid. Results: On admission to hospital, 10.43% of the patients surveyed had a BMI below 20 kg/m 2 , in 20.74% of patients serum albumin concentration was below 3.5 g/dl, indicating possible protein energy malnutrition. In addition, 21.02% had lymphocyte count below 1.5 Â 10 3 /mm 3 . During hospitalisation, deterioration in the nutritional status of the patient population occurred. On discharge from hospital, the percentage of patients with BMIo20 kg/m 2 increased to 11.21% and the percentage with low blood albumin (o3.5 g/dl) increased to 28.57%. On admission, vitamin C deficiency was present in 51.8% of patients, folic acid deficiency in 32%, vitamin E deficiency in 10%, vitamin B 12 deficiency in 6.8% and vitamin A deficiency in 1.4%. Vitamin deficiencies were present equally in malnourished, overweight and obese patients. Conclusions: In patients admitted to hospitals in Poland, malnutrition risk demonstrated by BMI was observed in 10.43% of patients. On the basis of biochemical indices, increased nutritional risk was demonstrated in 21% of patients. Vitamin malnutrition was seen in the majority of patients. A significant correlation between weight, BMI, arm circumference, blood lymphocyte count and the number of days spent in hospital was observed.

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“…Given that the mean hospitalisation length was 10 days, values of weight decline reaching 1% were regarded as significant and those exceeding 2% as dangerous (Blackburn et al, 1977).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nutritional status of patients hospitalised in Poland

et al. 2005

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“…The lean body mass was estimated from the creatinine-height index (CHI). CHI was the ratio of 24-h urinary creatinine excretion of the patient to a reference value based on ideal body weight [11]. The 24-h urinary creatinine excretion was averaged from results of three consecutive days and the mean intra-individual coefficient of variation was <10% in the 78 consecutive patients.…”

Section: Methodsmentioning

confidence: 99%

Prevalence and consequences of nutritional depletion in lung transplant candidates

Schwebel

Pin²,

Barnoud³

et al. 2000

Eur Respir J

107

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Nutritional status was studied in lung transplant (LT) candidates. The hypotheses were that nutritional depletion was highly prevalent and lean body mass depletion was a risk factor for a higher mortality both before and after LT.Of 78 consecutive patients listed for LT, 16 (21%) died while on the waiting list, eight (10%) were alive awaiting LT, and 54 (69%) received a graft. Mean age was 42.3 4.4 (mean SD). Thirty-eight per cent had a diagnosis of bronchiectasis or cystic fibrosis (BRO/CF), 33% of emphysema, 20% of idiopathic pulmonary fibrosis (IPF) and 8% of primary pulmonary hypertension. Body mass index (BMI) was 20.4 4.3 kg . m 2 , weight was 87.9 16.6% of ideal body weight (IBW).Patients were classed into four nutritional groups according to IBW and creatinine height index (CHI): I: weight <90% IBW and CHI <60% of predicted (28% of cases); II: weight <90% IBW and CHI $60% (27%); III: weight $90% IBW and CHI <60% (17%); IV: weight $90% IBW and CHI $60% (28%). Overall, 72% were depleted corresponding to groups I, II and III. Lean body mass depletion occurred despite normal weight in 17% of the cases (group III). Subjects with BRO/CF were mostly in groups I, II, III whereas IPF were concentrated in group III. Lean body mass depletion was associated with more severe hypoxaemia, reduced 6-minute walking distance and a higher mortality while awaiting. After LT, duration of mechanical ventilation, time spent in intensive care unit (ICU) was related to initial body composition. Survival after LT was lowest in group III.To conclude, nutritional depletion in lung transplant candidates is highly prevalent and should be more precisely assessed with a special reference to lean body mass since it has specific consequences both while awaiting and after lung transplant. Attempts should be made to increase lean body mass before lung transplant. Eur Respir J 2000; 16: 1050±1055.

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“…Recent weight loss is a very sensitive marker of a patient's nutritional status and should be measured very frequently (51). Weight loss of more than 5% in 1 month or 10% in 6 months before hospitalization has been shown to be clinically significant (52). Other measurements include height, triceps skinfold, and midarm circumference.…”

Section: Nutritional Assessment In Msmentioning

confidence: 99%