Thread by @CoryRohlfsen

#HospitalMedicine 101

What is difference between "failure to thrive" , "frailty" , and "malnutrition" in adults?

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@BrownJHM

FRAILTY is a loss of physiological reserve (usually from deconditioning, aging, cancer, a prolonged ICU stay, or loss of function after a stroke).

Pre-conditioning, re-conditioning, or assistive devices may optimize some function but most causes are not so easily reversible.

FAILURE TO THRIVE is loss of the ability to maintain independence given current support structures (or lackthereof).

Independence can be restored or optimized by providing more adequate psychosocial, community, or family support.

MALNUTRITION is loss of vital nutrients required for wound healing, fighting infection, and supporting other physiological functions. It can occur in the setting of normal caloric intake or high BMI.

If you recognize weight loss, muscle atrophy (e.g. sarcopenia), recurrent falls, recurrent hospitalizations, delirium, or poor wound healing, then think about whether or not 1 or more of these 3 conditions is at play.

When one is present, have high suspicion for the others!

When managing frailty, FTT, and/or malnutrition, know that any one of them in isolation may not get better unless you address the other two.

So how do you do that?

Gotta know your experts, team resources, and plan all dispo decisions with this in mind. A warm handoff to the PCP or geriatrician can help!

Any other tips? Add below...