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ARTICLE |

Is This Patient Malnourished? FREE

Allan S. Detsky, MD, PhD; Philip S. Smalley, MD; Jose Chang, MD
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JAMA. 1994;271(1):54-58. doi:10.1001/jama.1994.03510250070038
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PATIENTS 

Case 1  Ten days prior to being seen a 65-year-old man suffered a Wallenberg stroke involving the lateral medulla. This left him with difficulty swallowing. Since that time he had been treated with intravenous fluids, and attempts at eating led to mild aspiration with pneumonia. In that period he lost 6% of his usual body weight and was continuing to lose weight. He felt weak and was able to ambulate only with difficulty, both because of his stroke-related ataxia and generalized weakness. On physical examination there was an obvious squared-off appearance to his shoulders from subcutaneous tissue and muscle wasting. There was no edema.

Case 2  A 63-year-old man was admitted to the hospital for gastric resection of an obstructing gastric carcinoma. He was well until 6 weeks prior to admission when he began to notice the rapid onset of early satiety. This progressed to the point where he

REFERENCES

Bistrian BR, Blackburn GL, Hallowell E, et al.  Protein status of general surgical patients. JAMA . 1974;;230:858-860.
Bistrian BR, Blackburn GL, Vitale J, et al.  Prevalence of malnutrition in general medical patients. JAMA . 1976;;235:1567-1570.
Baker JP, Detsky AS, Wesson DE, et al.  Nutritional assessment: a comparison of clinical judgment and objective measurements. N Engl J Med . 1982;;306:969-972.
Detsky AS, Baker JP, O'Rourke K, et al.  Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr . 1987;;11:440-446.
Detsky AS, Baker JP, Mendelson RA, Wolman SL, Wesson DE, Jeejeebhoy KN.  Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparisons. JPEN J Parenter Enteral Nutr . 1984;;8: 153-159.
Detsky AS, Mendelson RA, Baker JP, Jeejeebhoy KN.  The choice to treat all, some, or no patients undergoing gastrointestinal surgery with nutritional support: a decision analysis approach. JPEN J Parenter Enteral Nutr . 1984;;8:245-253.
Windsor JA, Hill GL.  Weight loss with physiologic impairment: a basic indicator of surgical risk. Ann Surg . 1988;;207:290-296.
Detsky AS, McLaughlin JR, Baker JP, et al.  What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr . 1987;;11: 8-13.
Detsky AS, Baker JP, O'Rourke K, Goel V.  Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med . 1987;;107:195-203.
Buzby GP, Williford WO, Peterson OL, et al.  A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr . 1988;; 47:357-365.
The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group.  Perioperative nutrition in surgical patients. N Engl J Med . 1991;; 325:525-532.
Detsky AS.  Parenteral nutrition: is it helpful? N Engl J Med . 1991;;325:573-575.
Hirsch S, de Obaldia N, Petermann M, et al.  Subjective Global Assessment of nutritional status: further validation. Nutrition . 1991;;7:35-37.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Bistrian BR, Blackburn GL, Hallowell E, et al.  Protein status of general surgical patients. JAMA . 1974;;230:858-860.
Bistrian BR, Blackburn GL, Vitale J, et al.  Prevalence of malnutrition in general medical patients. JAMA . 1976;;235:1567-1570.
Baker JP, Detsky AS, Wesson DE, et al.  Nutritional assessment: a comparison of clinical judgment and objective measurements. N Engl J Med . 1982;;306:969-972.
Detsky AS, Baker JP, O'Rourke K, et al.  Predicting nutrition-associated complications for patients undergoing gastrointestinal surgery. JPEN J Parenter Enteral Nutr . 1987;;11:440-446.
Detsky AS, Baker JP, Mendelson RA, Wolman SL, Wesson DE, Jeejeebhoy KN.  Evaluating the accuracy of nutritional assessment techniques applied to hospitalized patients: methodology and comparisons. JPEN J Parenter Enteral Nutr . 1984;;8: 153-159.
Detsky AS, Mendelson RA, Baker JP, Jeejeebhoy KN.  The choice to treat all, some, or no patients undergoing gastrointestinal surgery with nutritional support: a decision analysis approach. JPEN J Parenter Enteral Nutr . 1984;;8:245-253.
Windsor JA, Hill GL.  Weight loss with physiologic impairment: a basic indicator of surgical risk. Ann Surg . 1988;;207:290-296.
Detsky AS, McLaughlin JR, Baker JP, et al.  What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr . 1987;;11: 8-13.
Detsky AS, Baker JP, O'Rourke K, Goel V.  Perioperative parenteral nutrition: a meta-analysis. Ann Intern Med . 1987;;107:195-203.
Buzby GP, Williford WO, Peterson OL, et al.  A randomized clinical trial of total parenteral nutrition in malnourished surgical patients: the rationale and impact of previous clinical trials and pilot study on protocol design. Am J Clin Nutr . 1988;; 47:357-365.
The Veterans Affairs Total Parenteral Nutrition Cooperative Study Group.  Perioperative nutrition in surgical patients. N Engl J Med . 1991;; 325:525-532.
Detsky AS.  Parenteral nutrition: is it helpful? N Engl J Med . 1991;;325:573-575.
Hirsch S, de Obaldia N, Petermann M, et al.  Subjective Global Assessment of nutritional status: further validation. Nutrition . 1991;;7:35-37.
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