Q&A: Members of ACDIS advisory board offer advice on querying for malnutrition
CDI Strategies, September 4, 2008
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Q: Where can I find information on how CDI staff should query for malnutrition? What criteria should they use?
Colleen Garry, RN, BS: I would look for clinical indications, therapeutic treatment, and also the clinical impact, as well as regulations (i.e., ensuring that you meet guidelines for secondary diagnosis coding). It would be helpful to partner with your facility's dieticians. We are currently working with them to learn what clinical indicators they use to define malnutrition.
William Haik, MD: Some clinical indicators of malnutrition/severe malnutrition include the following (note that there are others, but these are what I use):
- Malnutrition: IBW less than 85, but greater than 70, prealbumin less than 15, but greater than 5, albumin less than 3.5 but greater than 1.5
- Severe malnutrition: IBW less than 70, prealbumin less than 5 and albumin less than 1.5
Robert Gold, MD: A simple modality for malnutrition includes the following:
- Mild malnutrition: Short term undesired weight loss less than 10% of starting body weight
- Moderate malnutrition: Short term undesired weight loss 10-20% of starting body weight
- Severe malnutrition: Short term undesired weight loss greater than 20% of starting body weight
Also, you can view levels of malnutrition at the Merck Web site (see Table 3).
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