Individualised nutritional support in medical inpatients: a practical guideline

Malnutrition has been defined as a “state resulting from
lack of uptake or intake of nutrition, leading to altered
body composition and body cell mass, as well as to diminished physical and mental function and impaired clinical outcome from disease.” Particularly for the multimorbid
medical inpatient, there are multiple research studies linking malnutrition to adverse clinical outcomes independent
of type of acute and chronic illnesses. Importantly, recent
trials have shown that malnutrition is indeed a modifiable
risk factor with specific individualised nutritional support interventions started at hospital admission having positive
effects on the risk of complications, mortality, functional
outcomes, rehospitalisation and quality of life. Understanding the optimal use of nutritional support in patients
with acute illness is complex – as timing, route of delivery,
and the amount and type of nutrients can all affect patient
outcome. The aim of this narrative review is to provide a
practical guideline for pragmatic and evidence-based assessment and treatment of medical inpatients at nutritional
risk. We thereby focus on screening, patient assessment,
definition of individual nutritional goals and nutritional support interventions that help patients to reach these goals.
Keywords: nutrition, malnutrition, nutritional support