From the Guidelines
Protein-Calorie Malnutrition (PCM) is synonymous with malnutrition or undernutrition, defined as a state resulting from lack of intake or uptake of nutrition that leads to altered body composition and diminished physical and mental function.
Key Characteristics of Malnutrition
- Altered body composition, specifically decreased fat-free mass and body cell mass
- Diminished physical and mental function
- Impaired clinical outcome from disease
Diagnostic Criteria for Malnutrition
- The ESPEN criteria require prior fulfillment of nutritional risk criteria and either reduced body mass index (BMI) <18.5 kg/m2 or combined weight loss and reduced BMI 1
- The ASPEN and Academy criteria consider six malnutrition criteria, including low energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation, and hand grip strength, with at least two required for diagnosis 1
Subclassifications of Malnutrition
- Disease-related malnutrition with or without inflammation
- Malnutrition/undernutrition without disease
- Hunger-related malnutrition
- Socioeconomic or psychologic related malnutrition Note that while the term "Protein-Calorie Malnutrition" is not explicitly defined in the provided evidence, the definition of malnutrition or undernutrition provided is applicable in the context of real-life clinical medicine 1.
From the Research
Definition of Protein-Calorie Malnutrition (PCM)
- Protein-calorie malnutrition (PCM) is defined as the result of depleted body protein stores due to semistarvation 2
- It is a specific type of malnutrition defined as deficient intake or uptake of protein and energy that leads to physiologic alterations such as inflammation, loss in fat-free mass, and/or decreased response to medical treatment 3
- PCM is expressed as severe if the patient has two or more characteristics, including obvious significant muscle wasting, loss of subcutaneous fat, nutritional intake of <50% of recommended intake for 2 weeks or more, bedridden or otherwise significantly reduced functional capacity, and weight loss of >2% in 1 week, 5% in 1 month, or 7.5% in 3 months 4
- Protein energy malnutrition (PEM) is a common problem worldwide and occurs in both developing and industrialized nations, frequently resulting from socioeconomic, political, or environmental factors in the developing world, and chronic disease in the developed world 5
Key Characteristics of PCM
- Depleted body protein stores due to semistarvation 2
- Deficient intake or uptake of protein and energy 3
- Physiologic alterations such as inflammation, loss in fat-free mass, and/or decreased response to medical treatment 3
- Severe muscle wasting, loss of subcutaneous fat, and significant weight loss 4
Importance of PCM Definition
- PCM is associated with various acute and chronic complications, such as impaired wound healing, increased risk for infection, debility, and increased risk for rehospitalization 6
- Early recognition, prompt management, and robust follow up are critical for best outcomes in preventing and treating PCM 5