Abstract
Despite the fact that many methods have been used for assessing nutritional status throughout history, no gold standard for the identification of malnutrition exists today. This paper describes and evaluates different assessment methods. During the last three decades scientific studies have highlighted malnutrition as a common problem in hospital settings worldwide. In Norway, 39-54 % of hospitalised patients are at risk of malnutrition. Furthermore, it has been demonstrated that the prevalence increases during the hospital stay. Malnutrition is associated with decreased muscle, cardiac, respiratory and immune function as well as quality of life and impaired wound healing. These effects lead to increased morbidity and mortality, which significantly increase the duration and cost of hospital stays. The methods described in this paper are anthropometric measurements (weight, weight changes, Body Mass Index, skinfold thicknesses and muscle circumferences), serum proteins (albumin, transferrin, prealbumin and retinol-binding protein), creatinine/height index, Delayed Cutaneous Hypersensitivity, Bioelectric Impedance Analyse, Dual-Energy X-ray Absorptiometry and tests of muscle-function. In addition, various screening methods such as e.g., Nutrition Risk Score, Screening For Malnutrition and Subjective Global Assessment are described. The paper suggests that the problem of malnutrition needs further emphasis and that better routines and education of staff is crucial in order to improve the understanding and practice surrounding this topic. It is concluded that every hospitalised patient in Norway should be screened for malnutrition at admission using weight, weight changes, BMI and Nutrition Risk Score as measuring devices. Weight measurements should then be performed at least once a week.