Nutritional Risk Screening and Assessment

Malnutrition is an independent risk factor that negatively influences patients’ clinical outcomes, quality of life, body function and autonomy. Recent trials have demonstrated that malnutrition is a modifiable risk factor and nutritional support effectively reduces adverse outcomes associated with malnutrition. Thus early identification of patients at risk and of clinically apparent malnutrition is crucial in order to start adequate nutritional support. Nutritional risk screening, a simple and rapid first-line tool to detect patients at risk of malnutrition, should be performed systematically in patients at hospital admission. Patients with nutritional risk should subsequently undergo a more detailed nutritional assessment to identify and quantify specific nutritional problems. Such an assessment includes subjective and objective parameters such as medical history, current and past dietary intake (including energy and protein balance), physical examination and anthropometric measurements, functional and mental assessment, quality of life, medications and laboratory values. Nutritional care plans should be developed in a multidisciplinary approach, and implemented to maintain and improve patients’ nutritional condition. Standardized nutritional management including systematic risk screening and assessment may also contribute to reduced healthcare costs. Adequate and timely implementation of nutritional support has been linked with favorable outcomes such as a decrease in length of hospital stay, reduced mortality, and reductions in the rate of severe complications, as well as improvements in quality of life and functional status. The aim of this review article is to provide an overview of how nutritional screening and assessment can contribute to effective and well-structured nutritional management (process cascade) for patients admitted to the hospital.