Dr. Michael Meguid was a professor of surgery on duty at Boston City Hospital in August 1976 when he was called in one night for an emergency. An 18-year-old man named LeRoy had fallen from a ledge. LeRoy had a fractured thigh bone, which an orthopedic team worked quickly to repair. When they were finished, the patient was taken to the intensive care unit. He was going to make it, Meguid remembers thinking. To his surprise, LeRoy died 30 days later.
In the hospital, under the care of the orthopedic team, LeRoy’s only nourishment came from an intravenous drip. During those 30 days, LeRoy’s calorie intake was equivalent to “about two candy bars a day,” Meguid wrote in a 2015 Columbia Medical Review article.
LeRoy received about a sixth of the total nourishment that was required for him to survive and recuperate after two major surgeries. In the absence of that nourishment, his body resorted to converting his muscles to glucose. LeRoy’s medical records did not state it, Meguid says, but in reality the cause of his death was hospital-induced malnutrition.
More than 40 years after LeRoy’s death, new research indicates that malnutrition in hospital settings remains under-diagnosed and — even when detected — undertreated. Experts say this persistent lack of awareness about the dangers of malnutrition could be contributing to as much as $42 billion in healthcare costs, 54 percent higher readmission rates, hospital stays for malnourished patients that are twice as long as expected, and an unknown number of deaths.