Malnutrition and SGA Flashcards
6 characteristics to identify and document malnutrition
insufficient energy intake, unintentional wt loss, loss of body fat, loss of muscle mass, fluid accumulation, diminished functional capacity (2+ recommended for diagnosis)
according to GLIM criteria, diagnosis of malnutrition needs at least 1 ___ and 1 ____ criterion
phyenotypic (observable); etiologic (cause)
what are the phenotypic assessment criteria?
non-volitional wt loss, low BMI, reduced muscle mass
what are etiologic assessment criteria?
reduced food intake or assimilation, disease burden/inflammatory condition
diagnosis category according to underlying ethology:
chronic disease with inflammation, chronic disease with minimal or no perceived inflammation, acute disease or injury with severe inflammation, starvation including hunger/food shortage associated with socio-economic or enviro factors
BAPEN def of malnutrition:
state of nutrition which a deficiency or excess (or imbalance) of energy, protein, and other nutrients causes measurable adverse effects on tissue/body form, body function, clinical outcome (also includes over, under nutrition and micronutrients )
ESPEN def of malnutrition:
state resulting from lack of intake or uptake of nutrition that leads to altered body comp and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease
causes of malnutrition related to diet intake and absorption:
altered nutrient processing, inadequate intake, excess losses, malabsorption
primary etiological origins of malnutrition:
starvation, disease (acute or chronic), advanced aging
causes of non stress starvation:
socioeconomic/enviro, illness (anorexia nervosa, depression)
___ is the single best predictor and should be advocated as the primary measure for diagnosis of malnutrition
SGA
components of SGA:
unintentional weight loss, nutrition intake, GI symptoms, functional capacity, physical assessment, metabolic stress from disease
which three components of SGA carry most weight for clinical decision?
nutrition intake, unintentional weight loss, evaluation of muscle and fat
seeks to identify etiology on case by case basis as framework for determining malnutrition, modern understanding of how proinflammatory states affect malnutrition, has 2 step approach (ethology, severity)
ASPEN/AND
parameters to assess for presence of inflammation:
depleted albumin/prealbumin/transferrin, ^ CRP, hyperglycaemia, leukocytosis, leukopenia, low platelets, fever, tachycardia, rashes, discharge, swelling, pain with urination, productive cough, etc.
