Malnutrition (Undernutrition) — Adult Malnutrition (19+ Years of Age) — Clinical Pathway: Inpatient

Malnutrition (Undernutrition) Clinical Pathway — Inpatient

Adult Malnutrition (19+ Years of Age)

The selection of 2 or more criteria along with clinical judgement is required from within the possible 6 clinical characteristics for a malnutrition diagnosis.

Criteria may be met from items either in the “Moderate” or “Severe” levels. If only two criteria items are met, one from the moderate and one from severe, the final diagnosis should be of Moderate Degree of Malnutrition as two severe criteria items are needed for a Severe Degree of Malnutrition diagnosis.

Malnutrition Assessment

Etiology Moderate Severe
  Acute Illness/Injury Chronic Illness/Injury Social/Environmental
Circumstances1		 Acute Illness/Injury Chronic Illness/Injury Social/Environmental
Circumstances1
Clinical Characteristics below:            
Reduced Food Intake < 75% for
> 7 days		 < 75% for
> 30 days		 < 75% for
> 90 days		 < 50% for
> 5 days		 < 75% for
> 30 days		 < 50% for
> 30 days
Weight Loss 1-2% over 1 week > 2% over 1 week
5% over 1 month > 5% over 1 month
7.5% over 3 months > 7.5% over 3 months
10% over 6 months > 10% over 6 months
20% over 1 year > 20% over 1 year
Fat Loss Mild Moderate Severe Severe
Muscle Loss Mild Moderate Severe Severe
Fluid Accumulation Mild Moderate to Severe
Reduced Grip Strength2 N/A Measurably Reduced

Footnotes

  1. Social/Environmental circumstances include situations such as poverty, food insecurity, substance abuse, lack of nutrition related knowledge, inability to care/feed oneself.
  2. Measured by hand dynameter, rarely used at CHOP.

Reference