Malnutrition

The nutritional status of a healthy person is qualified by how the person is fed; quality and quantity of the food. In patients not only the food influences the nutritional status, but also the disease.The nutritional status influences the patientís reaction to the disease.

Definition of depletion

Deficit of nutrients in the clinical situation is only in some cases (for example anorexia nervosa) the only cause of malnutrition. Weight loss is caused by the catabolic influence of the disease, the decrease of fat free mass, also when there is no negative energy balance (van Leeuwen, 2000).


Refeeding syndrome

The refeeding syndrome is a dangerous disorder. It's first descibed in far east prisoners of war after the second word war. Starting to eat again after a period of prolonged starvation seemed to precipitate cardiac failure. The pathophysiology of refeeding syndrome has now been established.


Prevalence of malnutrition

Studley (1936) was the first who showed that weight loss is a risk factor for post-surgery complications. In post-surgical patients weight loss of more than 20% was associated with a higher mortality level: 33%. Mainly as a result of increased infection rates.

Consequences of malnutrition in the hospital

Loss of lean body mass has a negative effect on the organ function, wound healing, immune response to infections, healing and a longer hospital stay.