Nutritional status can change during hospitalization. To evaluate the degree of change, a nutrition screening program (NSP) that included admission and 3-week reassessment was implemented. NSP parameters were weight for height, percentage of weight loss, arm muscle circumference, triceps skinfold, serum albumin, and total lymphocyte count. Nutritional risk factors (NRF) were also recorded: cancer, nothing by mouth (NPO) for 3 or more days, loss of appetite, difficulty chewing or swallowing, persistent fever, and cancer chemotherapy or radiation therapy. Of 15,876 patients admitted during the period of March 1982 through December 1982, 583 (3.67%) were found to be suffering from malnutrition or to have NRFs. Of the 583 patients, 182 received nutritional support and were excluded from the study. The remaining patients were reassessed after 3 weeks and had significant decreases in nutritional parameters; 622 patients with deficits in one parameter (visceral or somatic) on admission had a significant decrease in all parameters (p less than .001) on 3-week assessment. There was a deterioration in nutritional status in those patients entering the hospital with NRFs only or with one low parameter.

The effects of parenteral nutrition on appetite during and after therapy are unclear. Previous studies done in animals, as well as in humans, are inconclusive. The purpose of this study was to investigate the effects of parenteral nutrition on voluntary oral intake of food. The study was done on ten stable patients receiving parenteral nutrition for transient dysfunction of their gastrointestinal tract. For each patient, a calorie count of the ingested food was obtained for 3 consecutive days. Parenteral calories were then decreased without the patient's knowledge. A calorie count for 3 more days was obtained following the day of change. The mean daily oral intake was 823 kcal when the mean daily parenteral nutrition intake was 2,902, providing a total of 3,723 kcal. When parenteral nutrition calories were decreased to a mean of 1,550, the mean daily oral intake increased to 1,396. This difference in oral and parenteral calorie intake was statistically significant (P less than .001). It can be concluded from this data that parenteral nutrition decreases voluntary oral intake of food. It is therefore suggested that if the gastrointestinal tract is functionally satisfactory, parenteral nutrition can be rapidly weaned off, provided oral consumption is monitored to assure adequacy.