Incidence and recognition of malnutrition in hospital.

To determine incidence of malnutrition among patients on admission to hospital, to monitor their changes in nutritional status during stay, and to determine awareness of nutrition in different clinical units. Prospective study of consecutive admissions. Acute teaching hospital. 500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery, and medicine for the elderly. Nutritional status of patients on admission and reassessment on discharge, review of case notes for information about nutritional status. On admission, 200 of the 500 patients were undernourished (body mass index less than 20) and 34% were overweight (body mass index > 25). The 112 patients reassessed on discharge had mean weight loss of 5.4%, with greatest weight loss in those initially most undernourished. But the 10 patients referred for nutritional support showed mean weight gain of 7.9%. Review of case notes revealed that, of the 200 undernourished patients, only 96 had any nutritional information documented. Malnutrition remains a largely unrecognised problem in hospital and highlights the need for education on clinical nutrition.