Food & Nutrition

Arab Journal of Food & Nutrition
16. Assessment of the Protein-Energy Malnutrition in Adult Hospitalized Patients
with Major Surgery (1995)
Sufyan Ahmad Mohammad Othman\ University of Jordan
Supervisor: Dr. Khader A. El-Masri
This study was conducted to assess the protein-energy status of a group of adult
patients with elective major surgery at admission and discharge from hospital. Thirty
patients participated in the study: thirteen from a private hospital and seventeen from a
governmental hospital. All had major intraabdominal or intrathoracic surgical
procedures.
The protein-energy status of the patients was assessed on the day of admission
(initial assessment) and on the day of discharge (final assessment). The following
parameters were used: serum albumin, serum transferrin, total lymphocyte count, midupper
arm circumference, mid-upper arm muscle circumference, upper arm muscle
area, biceps skinfold thickness, triceps skinfold thickness, upper arm fat area, recent
weight loss before admission, weight-for-height index and postoperative weight loss.
Food consumption was measured through all hospital days by the weighing method.
The protein and energy intake was determined for each patient, and compared with
protein and energy requirements. Patients were diagnosed for clinical symptoms of
protein-energy malnutrition.
The most frequent abnormality observed in both hospitals in the initial and final
assessments was moderate to severe somatic (muscle) protein depletion which
continued throughout the hospital stay, where the average length of hospitalization was
5.4 days (range, 2-10 days). In the initial assessment, 70% and 50% of the
governmental and private hospital groups, respectively, showed deficiencies as
indicated by upper arm muscle area. In the final assessment, arm muscle area indicated
that 80% and 60% of the governmental hospital and private hospital groups,
respectively, had muscle protein depletion.
In the initial assessment, low values of serum albumin, serum transferrin and
total lymphocyte count were prevalent in 3.3%, 33.3% and 16.7% of total patients,
respectively. Corresponding values in the final assessment were 20%, 66.7% and
36.7% for the three indicators, respectively. The same trend was observed for each
hospital group. The increase in the frequency of abnormal values in total patients was
only significant for serum albumin (p