Clinical Consequences of Malnutrition
Serious Health Consequences if Left Untreated
Malnutrition causes a marked decline in physical and psychological health and function.1 A significant body of evidence indicates that disease-related malnutrition adversely impacts recovery from disease, trauma and surgery, and is associated with increased morbidity and mortality both in acute and chronic diseases.2
Significantly increased infectious complications have been found in patients “at-risk” of malnutrition compared to “not-at-risk” patients.3 In addition to leading to a poorer quality of life,4 disease-related malnutrition prolongs the average length of a hospital stay by more than 30 percent in affected patients.5,6
Disease-related malnutrition can affect the whole body/metabolism and every organ of the patient with potentially serious consequences. The clinical and functional consequences of disease-related malnutrition include:4,5
- Impaired ability to fight infection, leading to increased mortality
- Impaired temperature regulation, leading to hypothermia
- Reduced wound healing, leading to infections and poor rehabilitation after fractures
- Inability to regulate salt and fluid, leading to over-hydration or dehydration
- Impaired psychosocial function, leading to depression, apathy, neglect, introversion
- Reduced muscle strength and increased fatigue, leading to inactivity, inability to self-care and cough, promoting pulmonary infections
- Decreased activity, leading to pressure ulcers, venous blood clots and embolism
- Impaired quality of life,1 leading to a vicious circle.
A Vicious Cycle of Health Consequences
A further consequence of disease-related malnutrition is the reduced ability to adequately respond to medical and pharmacological treatment, including chemotherapy. Malnutrition, disease and treatment can result in a vicious cycle which can only be overcome by treating the underlying disease and providing adequate nutritional support at the same time.6
- 1. a. b. Stratton RJ, Green CJ, Elia M. Disease-related malnutrition: an evidence based approach to treatment. Wallingford: CABI Publishing 2003.
- 2. Norman K, Pichard C, Lochs H et al. Prognostic impact of disease-related malnutrition. Clin Nutr 2008;27(1):5-15.
- 3. Sorensen J, Kondrup J, Prokopwicz J et al. Euro OOPS: an international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin Nutr 2008;27(3);340-349.
- 4. a. b. Elia M. Stratton RJ. A cost-benefit analysis of oral nutritional supplements in preventing uclers in hospital. Clin Nutr 2005;24:640-641.
- 5. a. b. Elia M, Russell C. Combating malnutrition recommendations for action. BAPEN 2009.
- 6. a. b. Kruizenga HM, de Jonge P, Seidell JC et al. Are malnourished patients complex patients? Health status and care complexity of malnourished patients detected by the Short Nutritional Assessment Questionnaire (SNAQ). Eur J Intern Med 2006;17(3):189-194.