Laboratory Biomarkers and Nursing Assessment in Nutritional Status: A Comprehensive Review

Abstract

Nutritional status is an important domain in the health domain, having influences on health recovery, prevention of diseases, and quality of life in many populations. Malnutrition, including undernutrition, overnutrition, and micronutrient deficiency, is associated with hospital length of stay, morbidity, and mortality. This systematic review explored the contributions of laboratory biomarkers and nursing assessments in assessing nutritional status. Laboratory biomarkers (e.g., serum albumin, prealbumin, micronutrient levels including vitamin D and zinc) can provide objective, quantifiable indicators of deficiencies of nutrients and metabolic abnormalities. However, the validity of laboratory biomarkers may be less than optimal as they are affected by many non-nutritional parameters such as inflammation and liver failure. Nursing assessments (dietary histories, anthropometric measurements, and physical exam types such as subjective global assessment) can provide a more holistic, high-level understanding of dietary patterns, physical status, and psychosocial aspects, but are constrained by time and nursing instrument validity. However, combining lab and nursing assessments improves the diagnostic power when identifying and diagnosing malnutrition (examples: MUST (Malnutrition Universal Screening Tool), case studies of older adults, surgical patients). Challenges in assessing nutritional status include variability in laboratory biomarkers, restricted time in nursing assessments (physical exam and dietetics), and difficulties associated with differences in populations. Future directions on assessments include metabolomics, wearables, and universal guidelines. This study will serve as a roadmap for improving nutrition assessment with an interprofessional collaborative approach and using innovative technologies and techniques.