Effects of energy deficiency: A focus on hospitalized and critically ill patients

Abstract

Malnutrition is a broad term used to describe any imbalance in nutrition that can develop as a result of dietary intake, increase in basal requirements, poor absorption, excessive nutrient losses due to an underlying disease state, or any combination of such factors. Upon admission, 15-60% of hospitalized patients are at risk or already qualify as being malnourished, with 30-40% of hospitalized patients experiencing further nutritional decline during their hospital course. When left unnoticed, malnourishment, especially in the hospitalized patient, is associated with several negative sequelae, including immunosuppression, higher infection rates, increased muscle loss with delayed functional recovery, impaired wound healing, increased risk of treatment complications, fewer ventilator-free days, longer hospital stays, higher overall treatment costs, and increased mortality rates. Several nutritional risk scoring systems exist to help clinicians risk-stratify these patients upon admission, with the goal of starting early nutritional therapy when deemed necessary.