The Michigan Medicine Adult Malnutrition Diagnosis Guidelines specify criteria for moderate and severe malnutrition.
Patient selection: adult
Parameters:
(1) unintended weight loss severity based on time interval (percent loss over time interval)
(2) body mass index (BMI) in kg per square meter
(3) inadequate diet
(4) decrease in muscle mass
(5) decrease in subcutenous fat
(6) wound healing
(7) handgrip strength
|
Parameter
|
Severe Malnutrition
|
Moderate Malnutrition
|
|
unintended weight loss
|
severe
|
moderate
|
|
BMI
|
< 18.5 kg per sq m
|
NA
|
|
inadequate diet
|
intake <= 50% of TEER for >= 1 month
|
intake <= 75% of TEER for > 1 week
|
|
|
intake <= 50% of usual intake for >= 1 month
|
intake <= 75% of usual intake for > 7 days
|
|
decrease muscle mass
|
moderate or severe
|
mild
|
|
decrease in subcutaneous fat
|
moderate or severe
|
mild
|
|
handgrip strength
|
|
more than 2 SD below mean for age and sex
|
where:
• TEER = total estimated energy requirements
• There are tables correlating percent weight loss over a time interval with level of malnutrition.
• The ICD-10 codes are E44 for moderate and E43 for severe malnutrition.
• Two standard deviations cover 97.5% of the normal distribution
