Hospital-acquired malnutrition (HAM) is a decline in nutritional status during a hospital stay independent of nutritional status on admission. It is believed to go unrecognized, especially when nutritional assessments are not performed.
Patient selection: hospitalized adult (>= 18 years of age)
Risk factors for hospital-acquired malnutrition include:
(1) longer length of stay
(2) higher 6-month readmission rate
(3) infection, trauma, complications, or other conditions associated with hypermetabolism (with nutritional needs greater than intake)
(4) failure to perform nutritional assessments periodically
(5) failure to monitor nutritional intake
(6) failure to provide parenteral nutrition when appropriate
(7) suboptimal nutritional status on admission (no reserves)
(8) failure to consult with a nutritionist
(9) oral diet with decreased absorption due to diarrhea, fistula, etc.
(10) patient dissatisfaction with hospital meal services or poor meal quality
(11) frequent meal-time interruptions
(12) prolonged NPO status
(13) decreased oral intake due to poor appetite, difficulty chewing, dysphagia, etc.
(14) failure to provide assistance to a patient with disabilities
Problems with detection:
(1) failure to perform a nutritional assessment on admission, with failure to establish a baseline
(2) sarcopenic obesity
(3) in hospital transfers
