Open Access Highly Accessed Open Badges Research

Malnutrition prevalence and precision in nutritional care differed in relation to hospital volume – a cross-sectional survey

Albert Westergren12*, Christine Wann-Hansson3, Elisabet Bergh Börgdal4, Jeanette Sjölander5, Rosmarie Strömblad6, Rosemarie Klevsgård7, Carolina Axelsson2, Christina Lindholm2 and Kerstin Ulander2

Author affiliations

1 Research and Development Unit, Central Hospital Kristianstad, Kristianstad, Sweden

2 School of Health and Society, Kristianstad University College, Kristianstad, Sweden

3 Faculty of Health and Society, Malmö University and Malmö University Hospital, Malmö, Sweden

4 Department of Emergency Medicine, Malmö University Hospital, Malmö, Sweden

5 Department of Clinical Nutrition, Lund University Hospital, Lund, Sweden

6 Hospital Management, Blekinge Hospital, Karlskrona, Sweden

7 Hospital Management, Lund University Hospital, Lund, Sweden

For all author emails, please log on.

Citation and License

Nutrition Journal 2009, 8:20  doi:10.1186/1475-2891-8-20

Published: 8 May 2009



To explore the point prevalence of the risk of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk and hospital volume.


A cross-sectional survey performed in nine hospitals including 2 170 (82.8%) patients that agreed to participate. The hospitals were divided into large, middle, and small sized hospitals. Undernutrition risk and overweight (including obesity) were assessed.


The point prevalence of moderate/high undernutrition risk was 34%, 26% and 22% in large, middle and small sized hospitals respectively. The corresponding figures for overweight were 38%, 43% and 42%. The targeting of nutritional interventions in relation to moderate/high undernutrition risk was, depending on hospital size, that 7–17% got Protein- and Energy Enriched food (PE-food), 43–54% got oral supplements, 8–22% got artificial nutrition, and 14–20% received eating assistance. Eating assistance was provided to a greater extent and artificial feeding to a lesser extent in small compared to in middle and large sized hospitals.


The prevalence of malnutrition risk and the precision in provision of nutritional care differed significantly depending on hospital volume, i.e. case mix. It can be recommended that greater efforts should be taken to increase the use of PE-food and oral supplements for patients with eating problems in order to prevent or treat undernutrition. A great effort needs to be taken in order to also decrease the occurrence of overweight.