30th July 2023

Assessment of malnutrition

Assessment includes investigation to determine the underlying cause, as well as assessment of a patient’s nutritional status and any physiological consequences of malnutrition.

Investigations

• Blood tests – including FBC and haematinics, U&Es, LFTs, TFTs, bone profile, vitamin D levels
• Screening tests for malabsorptive diseases – e.g. cystic fibrosis sweat test, autoantibodies for Coeliac disease, and other autoimmune diseases
• Stool sample for MC&S – assessing for chronic infectious causes
• Faecal elastase – for pancreatic insufficiency
• Focused imaging or endoscopy for any particular suspected disease – e.g. colonoscopy for potential lower GI malignancy, oesophagogastroduodenoscopy (OGD) in oesophageal disease, CT imaging for relevant malignancies
• Social assessments, if appropriate
• Cognitive assessments, if appropriate

Screening and assessment tools

Frameworks such as the MUST (Malnutrition Universal Screening Tool) can be used to assess a patient’s nutritional status, and in inpatient settings is performed as standard screening to identify any patients at risk of malnutrition. This is a five-step process, and involves assessment of BMI, any recent weight loss, and current acute illness. The full tool is provided in the References section.