ABSTRACT
With the advent of specialized nutritional support in the hospital and home setting, accurate nutritional assessment has become an integral part of overall patient evaluation, providing predictive information regarding outcome and directing future metabolic and nutritional interventions. Nutritional assessment in the hospitalized patient addresses the current critical nutritional state of the patient, including structural and functional status, and factors that may have led to over-or undernutrition. Objective measurements that contribute to a comprehensive nutritional assessment have been developed and intensely investigated. These tests are either static, assessing a defined amount or concentration of a particular substance, or dynamic, assessing a particular function of an individual organ or the whole body. Collectively, these tests should provide a nutritional assessment to predict patient outcome, morbidity, and mortality. Nonetheless, despite elaborate and well-developed techniques of evaluation, nutritional assessment remains an evasive science, requiring the accumulation of data from a variable number of tests in an effort to provide an objective and useful appraisal of nutritional status. Comprehensive nutritional assessment involves accurate history taking with emphasis on recent weight gain or loss and the factors contributing to a change in the patient's usual condition. Careful physical examination observing subtle signs of metabolic or nutritional abnormalities is essential. Biochemical parameters are used extensively to confirm initial impression or provide more accurate data as to specific functional or structural status. Reliance on any single parameter, whether it be patient history, physical examination, biochemical tests, or metabolic measurements, is fraught with hazard and provides inaccurate data for patient evaluation.
