{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:19:27Z","timestamp":1761862767558,"version":"build-2065373602"},"reference-count":36,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[1992,7,1]],"date-time":"1992-07-01T00:00:00Z","timestamp":709948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[1992,7]]},"abstract":"<jats:p>Clinical nutrition assessment has identified two types of protein\u2010calorie malnutrition (PCM), a stress\u2010induced hypoalbuminemic form (HAF\u2010PCM) and a marasmic form (MF\u2010PCM) generated by adaptation to starvation. This study evaluated the differences between these two patterns of PCM with regard to precipitating factors and the clinical sequelae of mortality, cost of total parenteral nutrition, length of hospitalization, and rate of sepsis and nosocomial infection. Of 220 patients receiving total parenteral nutrition over a 12\u2010month period (0.7% of 30, 127 admissions), 180 were included in this study. HAF\u2010PCM was diagnosed in 45% and MF\u2010PCM in 25% of study patients. HAF\u2010PCM was more common in older age groups. Women had PCM less often than did men (57% vs 83%), but whereas men developed both forms of PCM equally, women were more likely to develop HAF\u2010PCM. Prolonged mechanical ventilation increased the likelihood of both patterns, whereas the presence of malignancy, concomitant organ failure, trauma, burns, or surgery did not increase the likelihood of developing either pattern of PCM. HAF\u2010PCM increased the length of hospitalization by 29% and the cost of total parenteral nutrition by 42%. The presence of HAF\u2010PCM increased fourfold the odds of dying, and the odds of developing nosocomial infection and sepsis almost 2.5 times above that seen in its absence. MF\u2010PCM had no clinical effect of its own on any of the outcome parameters, but instead exerted only an interactive synergistic effect with HAF\u2010PCM on length of hospitalization and cost of total parenteral nutrition. <jats:italic>(Journal of Parenteral and Enteral Nutrition<\/jats:italic> <jats:bold>16:<\/jats:bold>337\u2013342, 1992)<\/jats:p>","DOI":"10.1177\/0148607192016004337","type":"journal-article","created":{"date-parts":[[2008,5,14]],"date-time":"2008-05-14T19:51:26Z","timestamp":1210794686000},"page":"337-342","source":"Crossref","is-referenced-by-count":73,"title":["Differentiating Subtypes (Hypoalbuminemic vs Marasmic) of Protein\u2010Calorie Malnutrition: Incidence and Clinical Significance in a University Hospital Setting"],"prefix":"10.1002","volume":"16","author":[{"given":"Stephen A.","family":"Mcclave","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas 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