Multidisciplinary consensus on the approach to hospital malnutrition in Spain.

Rationale: Disease-related malnutrition constitutes a highly prevalent healthcare problem with high costs asso- ciated. In Spain, the prevalence of malnutrition in hospi- talized patients has been reported from 30% to 50%. Objectives: Main purposes of this consensus document were to establish recommendations that facilitate deci- sion-making and action to prevent and early-diagnose disease-related hospital malnutrition, on the manage- ment of nutritional support methods and actions to evalu- ate nutritional treatment compliance and efficacy. Methods: A systematic bibliographical search of authors was performed, complemented by updated bibliography by author references up to 2010. From this review, some recommendations were defined, modified and critically evaluated by the representatives of scientific societies in a consensus conference (Dec 2010) following a structured brainstorming technique: the Metaplan ® technique. A double validation process was undertaken until final rec- ommendations were obtained. Results: 30 consensus recommendations for the pre- vention and management of hospital malnutrition are presented in this document. Recommendations cover all clinical care settings as well as prevention, screening, diagnosis, treatment and follow-up of disease-related malnutrition. Conclusions: Nutritional screening is strongly recom- mended at all clinical settings when nutritional risk fac- tors are identified or there is clinical suspicion of malnu- trition. Nutritional assessment should be designed and performed according to centers' resources, but clearly identified protocols should be available.