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Extent and Impact of Malnutrition in Critically Ill Patients

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Diet and Nutrition in Critical Care

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Abstract

While malnutrition is most prevalent in developing countries, it is present, yet usually unrecognized and untreated in a large percentage of acutely and critically ill patients worldwide. The diagnosis of malnutrition has been challenging due to the absence of a unifying definition. Patients may have combinations of chronic starvation complicated by chronic disease-related malnutrition and exacerbated by acute disease-related malnutrition, producing rapid and profound declines in nutritional status. However, the lack of recognition and treatment of malnutrition contributes to major, yet avoidable, nosocomial complications and death, as well as prolonged length of stay and increased readmission rates. The cost of neglecting patients’ nutritional status is huge in financial, resource, and human losses. Screening tools and treatment guidelines are widely available.

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Abbreviations

ADRM:

Acute disease-related malnutrition

AKI:

Acute kidney injury

ASPEN:

American Society for Parenteral and Enteral Nutrition

AUD:

Australian dollar

BMI:

Body mass index

BMI Z-score:

Normal range distribution of BMI

CDRM:

Chronic disease-related malnutrition

DEXA:

Dual-energy X-ray absorptiometry

DRG:

Diagnosis-related group

ESPEN:

European Society for Parenteral and Enteral Nutrition

ICU:

Intensive care unit

LBM:

Lean body mass

LOS:

Length of stay

MNA:

Mini-Nutritional Assessment

MOSF:

Multiple organ system failure

MUST:

Malnutrition Universal Screening Tool

NRS:

Nutritional risk screening

NS:

Nutrition support

RR:

Relative risk

SAPS II:

Simplified Acute Physiology Score II

SRM:

Starvation-related malnutrition

US:

United States

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Authors and Affiliations

  1. Division of Hospital Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Lisa L. Kirkland

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  1. Lisa L. Kirkland
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Correspondence to Lisa L. Kirkland .

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Editors and Affiliations

  1. Department of Nutrition, King's College London, London, United Kingdom

    Rajkumar Rajendram

  2. School of Medicine, King's College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

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Kirkland, L.L. (2014). Extent and Impact of Malnutrition in Critically Ill Patients. In: Rajendram, R., Preedy, V., Patel, V. (eds) Diet and Nutrition in Critical Care. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8503-2_62-2

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  • DOI: https://doi.org/10.1007/978-1-4614-8503-2_62-2

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