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Previous Volume 336:738 March 6, 1997 Number 10 Next

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Second edition. Edited by Josef E. Fischer. 831 pp., illustrated. Boston, Little, Brown, 1996. $175. ISBN 0-316-28390-8.

Malnutrition is the number-one risk factor for mortality, accounting for 12 percent of deaths worldwide — twice the mortality from tobacco use or hypertension. In the United States, 50 percent of patients are moderately malnourished on admission to the hospital. What is worse, nutritional status deteriorates during hospitalization. This is especially true of patients undergoing surgery, in whom malnutrition is particularly deleterious. Clinical nutrition is neglected in most U.S. medical schools, although annual U.S. costs exceed $4 billion for nutritional therapies, the actual hospital costs of malnourished patients are more than three times those of well-nourished patients, and there is . . . [Full Text of this Article]

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