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Research References Index
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Nutrition for Wound Healing
Research References Index

Nutrition for Wound Healing

 
RESOURCE TITLE:

Improving nutritional screening of hospitalized patients: the role of prealbumin.

Robinson MK, Trujillo EB, Mogensen KM, Rounds J, McManus K, Jacobs DO.

AffiliationDepartment of Surgery, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts 02115, USA. mkrobinson@partners.org

JournalJPEN J Parenter Enteral Nutr. 2003 Nov-Dec;27(6):389-95; quiz 439.

Comment in JPEN J Parenter Enteral Nutr. 2004 Jul-Aug;28(4):281; author reply 281.

ABSTRACT

BACKGROUND: Limited resources prevent hospitals from having all patients formally evaluated by a nutrition expert. Thus, hospitals rely on nutrition-screening tools to identify malnourished patients. The purpose of this study was to determine the effectiveness of a nutrition-screening protocol, prealbumin (PAB), retinol binding protein (RBP), and albumin (ALB) in identifying malnourished hospitalized patients.

METHODS: A nutrition screening protocol was prospectively used in medical and surgical patients and consisted of a nurse administering a questionnaire to patients and requesting formal evaluation by a registered dietitian (RD) only if nutritional issues were identified. Patients also had ALB, PAB, and RBP drawn, which were used to both screen and identify the malnourished. PAB, RBP, and ALB were compared as predictors of RD classification of patient nutritional status.

RESULTS: The nutrition-screening protocol classified 104 of 320 patients (33%) as malnourished. However, 43% of the patients were not deemed at nutritional risk according to this protocol and therefore did not receive RD assessment. PAB was a significant predictor of RD-determined nutritional status (p < .05), whereas RBP and ALB were not. PAB screening/assessment identified 50% (162/320) of the patients as being malnourished. Notably, 50% of the patients (71 of 142) who were not evaluated by an RD were identified as malnourished using PAB criteria. The nutrition-screening protocol took 1.2 days longer to determine malnourishment compared with PAB (p = .0021).

CONCLUSIONS: Use of screening questionnaires may miss or delay identification of malnourished patients. PAB screening/assessment may improve identification of those patients requiring nutrition intervention and thus enhance the care of hospitalized individuals.

LEARN MORE:  http://pen.sagepub.com/content/27/6/389.long

 

Related references...

 
Stadelmann WK, Digenis AG, Tobin GR. Physiology and healing dynamics of chronic cutaneous wounds. Am J Surg 1998;176:26S- 38S.
 
Stadelmann WK, Digenis AG, Tobin GR. Impediments to wound healing. Am J Surg 1998;176:39S-47S.
 
Senapati A, Thompson RP. Zinc deficiency and the prolonged accumulation of zinc in wounds. Br J Surg 1985;72:583-584.
 
Robinson MK,Trujillo EB,Mogensen KM, et al: Improving nutritional screening of hospitalized patients:The role of prealbumin. JPEN 2003;27:389-395.
 
Ehrlichman RJ, Seckel BR, Bryan DJ, Moschella CJ. Common complications of wound healing. Prevention and management. Surg Clin North Am 1991;71:1323-1351.
 
Ann Surg. 1990 March; 211(3): 269–276. PMCID: PMC1358431 Copyright notice Levenson SM, Gruber CA, Rettura G, et al. Supplemental vitamin A prevents the acute radiation-induced defect in wound healing. Ann Surg 1984;200:494-512.
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