12.1. METHODS OF ASSESSMENT OF NUTRITIONAL
CONDITION
Protein-energy malnutrition on various diseases and its close association with the development of complications causes the need for reliable methods of diagnostic and correction when it is still possible to prevent irreversible dystro-phic changes in organs.
Assessment of the nutritious status (NS) - a paramount step in the treatment of the patient and correction of the protein-energy insufficiency.
12.1.1. Anamnesis
The anamnestic signs of possible disturbances of nutritious status include:
• change of the dynamics of body mass, a diet and appetite based on the recollections of the patient and their relatives, and data in the ambulatory medical record;
• digestive organs surgeries;
• chemoand radiotherapy;
• alcohol abuse;
• social-economic and marital status;
• anorexia, dyspepsia, vomiting, diarrhea;
• pregnancy, lactation, pathological periods;
• acute or chronic blood loss;
• frequent infectious diseases;
• diseases leading to disturbance of chewing, swallowing.
12.1.2. Clinical presentation
Leading clinical signs of the nutritious status insufficiency:
• syndrome of progressing loss of body mass;
• asthenovegetative syndrome;
• persistent decrease in working capacity, including professional;
• syndrome of polyglandular endocrine insufficiency;
• morphofunctional changes of the digestive organs (atrophy, secretion suppression, disturbance of digestion and imbibition, dysbacteriosis, etc.);
• circulator hypoxia of organs and tissues;
• immunodeficiencies;
• polyhypovitaminoses.
12.1.3. Body mass
Body mass (BM) - the simplest and informative indicator of the trophic status. Calculation of ideal body mass (BMid) is effected using the formula. Brock?s formula: