Detection of Dangerous Malnutrition

Abstract

The assessment of malnutrition by simple methods was studied in 120 patients undergoing elective major abdominal surgery to determine which index was of the most value in predicting postoperative complications. Weight for height and weight loss were of little significant value; serum albumin <35 g/l was more significant (p < 0.05) but predicted only a quarter of those patients who developed serious complications. Measurements of muscle stores by anthropometry (arm and forearm muscle circumference) predicted nearly half the patients (p < 0.01). By far the most useful index was hand‐grip dynamometry, which predicted 90% of those who developed complications (p < 0.001). The incidence of serious complications was 6 times greater in those patients with a low grip strength. Hand‐grip dynamometry appears to be a useful screening test of patients at risk, and a valuable additional test for nutritional assessment.