The prevalence of malnutrition in patients with human immunodeficiency virus on admission to hospital
The prevalence of malnutrition in new hospital admissions is between 9 and 60% but it is widely acknowledged that malnutrition is often unrecognized ( Lennard-Jones, 1992; McWhirter & Pennington, 1994; Karlsson & Nordstrom, 2001). In patients with human immunodeficiency virus (HIV), weight loss and wasting are common features, which have been extensively studied and shown to have significant clinical implications. Loss of 5–10% of body weight has been demonstrated to be highly predictive of the development of opportunistic infections and death ( Wheeler et al., 1998 ). However, few studies have examined the frequency of undernutrition in these patients. The aim of the study was to determine the prevalence of malnutrition in HIV patients admitted to a dedicated ward at the Chelsea and Westminster Hospital. Method:
Data on height, weight and weight change were collected from patients admitted consecutively between January and April 2002. Body mass index (BMI) and, where a reliable weight history was available, percentage weight loss was calculated. Patients at high risk of malnutrition were identified using the screening tool for adults at risk of malnutrition ( BAPEN, 2000), which uses a combination of BMI and percentage body weight loss to determine overall risk. Patients with BMI <18.5 kg m−2 and with weight loss >10% were considered to be at high risk of malnutrition. Results:
Data were collected on 120 admissions, of which 100 were eligible for inclusion. Thirty seven patients were found to be at high risk of malnutrition, 19 of whom had a BMI <18.5 kg m−2 and 18 of whom had reported a body weight loss greater than 10% ( Table 1). Only six patients of 32 patients in the high-risk group were identified in both the BMI and weight loss categories. Discussion:
The results show that a substantial proportion of HIV patients admitted to hospital are malnourished. Using a single measure of identifying patients at greatest risk of malnutrition (either BMI <18.5 kg m−2 or weight loss >10%) can underestimate the number of patients who may be at nutritional risk and require further nutritional assessment and possibly nutritional support.
Document Type: Abstract
Affiliations: 1: Department of Nutrition and Dietetics, Royal Brompton and Harefield NHS Trust, Royal Brompton Hospital, Sydney Street, London SW3 6NP 2: Dietetic Department, Chelsea and Westminster Hospital 3: University of North London, UK
Publication date: October 1, 2003