Impact of nutrition support on patient outcome and hospital costs.

Outcome data for patients malnourished due to gastrointestinal problems requiring surgery show that morbidity and mortality are improved when nutrition support is provided. The effect is greatest for those patients whose prognostic nutrition index is high. For these individuals in particular, this support is mandatory for the other therapies provided to be effective. The principle underlying this support is the fact that protein deficit cannot be repaired by carbohydrates or fat, whether from body stores or an external source. Instead, protein has to be provided, either enterally or parenterally. Providing protein as part of nutrition support before, rather than after, the patient deteriorates is the key to improved outcome and cost efficiency. The small percentage of hospital patients who require this intervention can be identified by routine measuring of serum albumin levels and are those with levels below 3.5 g/dL.