By Mr. Zaher Toumi , Dr. Suzanne Lawson
Corresponding Author Mr. Zaher Toumi
General Surgery- Pennine Acute Hospitals NHS Trust, - United Kingdom OL1 2JH
Submitting Author Mr. Zaher Toumi
Other Authors Dr. Suzanne Lawson
Tameside General Hospital, - United Kingdom


Nutrition, Surgery, General Surgery, Outcomes

Toumi Z, Lawson S. Nutritional Screening in a District Hospital in the Greater Manchester Area. WebmedCentral SURGERY 2011;2(9):WMC002188
doi: 10.9754/journal.wmc.2011.002188
Submitted on: 12 Sep 2011 04:19:47 PM GMT
Published on: 13 Sep 2011 06:27:03 PM GMT


Background and objectives:
National guidelines state that nutritional screening should take place for all hospital inpatients on admission and should be repeated weekly. Nutritional screening should include measuring the patient's weight and BMI and asking about any unintentional weight loss. We aimed to find out if nutritional screening was takes place at our district hospital and how useful that screening is.


We included all patients who were admitted to the surgical wards at a district hospital in Greater Manchester over a three-week period in 2010 in our audit. We checked whether these patients underwent initial and ongoing nutritional screening. We compared the group which had some form of nutritional screening with the group which did not have any nutritional screening in regards to length of stay and haematological and biochemical markers of hydration and nutritional status.


One hundred and thirty nine consecutive patients were admitted during the audit period. 50.4% were males (n=70) and 49.6% were females (n=69). Median age of patient was 56 (range 18 - 90). Median length of stay was 2 days (range 0 - 52). Length of stay in hospital was three days or less for 91 patients and only 48 patients stayed more than 3 days.
Excluding patients who stayed three days or less in hospital, 65% of patients had some form of nutritional screening during their stay in hospital (31 out of 48).
Excluding patients who stayed three days or less in hospital, patients who had screening stayed in hospital longer than those who did not have any screening (7 days vs. 5 days, p=0.027).
Among the group, which stayed 4 to 7 days in the hospital, there was no biochemical or haematological evidence of improvement in the hydration or nutritional status of patients who had nutritional screening.
Similarly, among the group which stayed more than 7 days, there was also no biochemical or haematological evidence of improvement in nutritional state of those who had nutritional screening.


When comparing the group that had no nutritional screening to the group which had some form of nutritional screening, there was a significant difference in length of stay between the two groups (less in those who didn't have nutritional screening). This could be interpreted as a worsening of outcomes following nutritional screening. However, it might be caused by an increased chance to have some form of nutritional screening performed if patients stayed in hospital for longer. Apart from the previous, there was no difference in outcomes between the two groups.


Nutritional screening for surgical patients at our district hospital, in its current format, is inadequate. It is not universal and when it is done, it is frequently incomplete. In its current format, it does not seem to lead to an improvement in hydration or nutritional status.

Source(s) of Funding

Neither sough nor received

Competing Interests



This article has been downloaded from WebmedCentral. With our unique author driven post publication peer review, contents posted on this web portal do not undergo any prepublication peer or editorial review. It is completely the responsibility of the authors to ensure not only scientific and ethical standards of the manuscript but also its grammatical accuracy. Authors must ensure that they obtain all the necessary permissions before submitting any information that requires obtaining a consent or approval from a third party. Authors should also ensure not to submit any information which they do not have the copyright of or of which they have transferred the copyrights to a third party.
Contents on WebmedCentral are purely for biomedical researchers and scientists. They are not meant to cater to the needs of an individual patient. The web portal or any content(s) therein is neither designed to support, nor replace, the relationship that exists between a patient/site visitor and his/her physician. Your use of the WebmedCentral site and its contents is entirely at your own risk. We do not take any responsibility for any harm that you may suffer or inflict on a third person by following the contents of this website.

0 comments posted so far

Please use this functionality to flag objectionable, inappropriate, inaccurate, and offensive content to WebmedCentral Team and the authors.


Author Comments
0 comments posted so far


What is article Popularity?

Article popularity is calculated by considering the scores: age of the article
Popularity = (P - 1) / (T + 2)^1.5
P : points is the sum of individual scores, which includes article Views, Downloads, Reviews, Comments and their weightage

Scores   Weightage
Views Points X 1
Download Points X 2
Comment Points X 5
Review Points X 10
Points= sum(Views Points + Download Points + Comment Points + Review Points)
T : time since submission in hours.
P is subtracted by 1 to negate submitter's vote.
Age factor is (time since submission in hours plus two) to the power of 1.5.factor.

How Article Quality Works?

For each article Authors/Readers, Reviewers and WMC Editors can review/rate the articles. These ratings are used to determine Feedback Scores.

In most cases, article receive ratings in the range of 0 to 10. We calculate average of all the ratings and consider it as article quality.

Quality=Average(Authors/Readers Ratings + Reviewers Ratings + WMC Editor Ratings)