Adult malnutrition screening, prevalence and management in a United Kingdom hospital: cross-sectional study

The objectives of the present cross-sectional study were to assess the screening, prevalence and management of malnutrition and identify any co-existence with obesity in adult hospital in-patients. The Malnutrition Universal Screening Tool (MUST) was applied to all medical, surgical, orthopaedic and critical care in-patients in an acute hospital in North-East England on a single day in 2007. An audit was also performed of malnutrition screening using a locally developed tool. Patients were excluded from study if they had been an in-patient less than 24 h or if discharged on the day of study. Of 328 patients meeting inclusion criteria, 100% had full data collection (143 males, 185 females, median length of stay 8d (range 1-90d), median age 76 years (range 17-101 years)). Only 226 patients (68.9%) had been screened for malnutrition and thirty-one (13.7%) were at highest malnutrition risk, of which only 45-2% were appropriately referred to nutrition and dietetic services. The prevalence of malnutrition (MUST >= 1) was 44%. The prevalence of highest risk (MUST >= 2) increased with age (20.6% <60 years, 29.7% 60-79 years and 39-4% >= 80 years). In total 37.8% (n 70) of female patients had a MUST score of >= 2 compared with 24-5% (n 35) of males. Obesity (BMI > 30 kg/m(2)) was identified in 9.5% of those with a MUST score >= 2. We have shown that malnutrition is a common problem affecting over 40% of patients in this hospital-wide study. Currently malnutrition is often unrecognised and undertreated in clinical practice. Hospitals must develop comprehensive strategies to both identify and treat in-patients with this common condition.