Take home points and references

TAKE HOME POINTS

1.Use Malnutrition screening tools to identify high risk patients, as early intervention can improve patient outcomes.

2.Patients with normal BMI may still be at risk for malnutrition if they have recent unplanned rapid weight loss and /or prior or anticipated poor nutritional intake for > 5 days.

3.Patients who are severely malnourished should be monitored closely for Refeeding syndrome during caloric re-introduction.

4.Patients at high risk should be started on 50% of their estimated caloric needs and advanced gradually to goal. Supplement Thiamine 100mg/day in those with severe starvation or signs of thiamine deficiency

REFERENCES:

Murphy J, Mayor A, Forde E. Identifying and treating older patients with malnutrition in primary care: the MUST screening tool. Br J Gen Pract. 2018 Jul;68(672):344-345. PMID: 29954811; P

Hummell AC, Cummings M. Role of the nutrition-focused physical examination in identifying malnutrition and its effectiveness. Nutr Clin Pract. 2022 Feb;37(1):41-49. Epub 2021 Nov 9. PMID: 34751967.
Silva JSV, Seres DS, Ayers P; Parenteral Nutrition Safety and Clinical Practice Committees, American Society for Parenteral and Enteral Nutrition. ASPEN Consensus Recommendations for Refeeding Syndrome. Nutr Clin Pract. 2020 Apr;35(2):178-195. Epub 2020 Mar 2. PMID: 32115791.

National Institute for Health and Clinical Excellence (NICE). Nutrition support in adults Clinical guideline CG32. 2000

Malnutrition Risk scores

Malnutrition Universal Screening tool:https://www.mdcalc.com/calc/10190/malnutrition-universal-screening-tool-must

NRS 2022: https://www.mdcalc.com/calc/4012/nutrition-risk-screening-2002-nrs-2002

Nutritional risk Index:https://www.mdcalc.com/calc/10202/nutritional-risk-index-nri

Case index