Ruxton C H S, Gordon J, Kirkwood L, McMillan B, Ryan E
Nutrition Communications, Front Lebanon, Cupar, UK.
J Hum Nutr Diet. 2008 Feb;21(1):81-90. doi: 10.1111/j.1365-277X.2007.00844.x.
Hospital malnutrition (undernutrition) continues to attract concern. The implementation of standards for food and fluids in Scotland provided the stimulus for an audit of current practices in NHS Fife hospitals in order to provide baseline data with which to evaluate progress.
One hundred and fifty in-patients were recruited from wards likely to yield those with a high risk of malnutrition. Using patient records and anthropometry, data were collected on weight, weight change, body mass index (BMI), mid-upper-arm circumference (MUAC), dietetic referral, therapeutic diets and patients' perceptions of nutritional status. Malnutrition was estimated by comparing BMI, weight change and MUAC with the Malnutrition Universal Screening Tool (MUST) and standards published by the Scottish Intercollegiate Guidelines Network (SIGN).
Depending upon the standard used, the minimum risk of malnutrition varied from 14 to 25%. The prevalence was lower than that reported previously, although methods were not directly comparable. Obesity was also evident with 42% of patients having a BMI > 25. Mean weight change from admission to audit was +0.4 kg, with a wide range (-11 kg to +13 kg). Most patients identified as malnourished were referred to the dietitian or given nutritional support.
Fewer patients were at risk of malnutrition than expected. However, improving the provision of food and fluids remains a priority in Fife as malnutrition and eating problems can occur across the entire BMI spectrum.
医院营养不良（营养不足）问题持续受到关注。苏格兰食品和液体标准的实施促使对法夫国民保健服务医院的当前做法进行审计，以便提供用于评估进展情况的基线数据。
从可能收治营养不良高风险患者的病房招募了150名住院患者。利用患者记录和人体测量学方法，收集了体重、体重变化、体重指数（BMI）、上臂中部周长（MUAC）、饮食转诊、治疗性饮食以及患者对营养状况的认知等数据。通过将BMI、体重变化和MUAC与营养不良通用筛查工具（MUST）以及苏格兰校际指南网络（SIGN）发布的标准进行比较，估算营养不良情况。
根据所使用的标准，营养不良的最低风险在14%至25%之间。尽管方法不可直接比较，但患病率低于先前报告的水平。肥胖问题也很明显，42%的患者BMI>25。从入院到审计期间的平均体重变化为+0.4千克，范围较广（-11千克至+13千克）。大多数被认定为营养不良的患者被转诊至营养师处或接受了营养支持。
存在营养不良风险的患者比预期的要少。然而，在法夫，改善食品和液体供应仍然是一个优先事项，因为在整个BMI范围内都可能出现营养不良和饮食问题。
