Serum Proteins as Markers of Nutrition: What Are We Treating?

IDENTIFYING MALNUTRITION The high incidence of malnutrition in the hospital setting was first described in the 1974 publication, “The Skeleton in the Hospital Closet” (1). Over time, the presence of malnutrition has been consistently correlated with increased length of stay, clinical deterioration, increased use of hospital resources, and increased risk of complications (2). Because of the deleterious effects of malnutrition on morbidity and mortality, identifying patients at nutritional risk early should improve outcomes and decrease costs. However, malnutrition is sometimes difficult to define. Is malnutrition a deficiency in caloric intake, protein intake, or a deficiency in both? Could a deficiency in micronutrients such as vitamins and minerals be defined as malnutrition? Is malnutrition defined by a specific clinical condition, or is it the presence of multiple conditions? Although there is no clear consensus among health care NUTRITION ISSUES IN GASTROENTEROLOGY, SERIES #43