En
Abstract
Background
Estimating the prevalence of malnutrition among the hospitalized patients is challenging. Malnutrition is associated with a variety of poor outcomes including long hospital stay and mortality as well as increased hospital costs.
Aim
The study aims to assess the risk of malnutrition in hospitalized patients and to identify the main factors and clinical parameters associated with the risk of malnutrition.
Materials and methods
The researchers conducted a cohort study to screen for the risk of malnutrition following hospital admission in a population of adult patients recently admitted to a tertiary care hospital in Egypt using the malnutrition universal screening tool (MUST) and simplified nutritional appetite questionnaire and to assess the effect of malnutrition on duration of hospital stay.
Results
The study included 1000 patients with a mean age of 49±13.7 years. The median duration of hospitalization was 5 (4–7) days, with a range of 2–30 days. All those included in the study presented a risk for malnutrition (1.0% medium risk and 99.0% high risk). High risk malnutrition was most common among those with diabetes (P=0.001) and renal problems (P=0.03), and in patients who had been admitted for longer hospital stay (P=0.037). A statistically positive correlation was seen between the age of the patients (P=0.031, r=−0.031), length of stay (P=0.353, r<0.001), and MUST score. However, there was a statistically significant negative weak correlation between simplified nutritional appetite questionnaire (appetite) (P=0.003, r=−0.094), BMI (P<0.001, r=−0.120), albumin (P<0.001, r=−0.117), and MUST score. Malnourished patients had a longer hospital stay than those who are well nourished (P=0.002).
Conclusion
We have identified an overall malnutrition risk of 100% among the hospitalized patients and ascertained that malnutrition is a risk of prolonged length of hospital stay. MUST questionnaire should be implemented to screen and early recognize the malnourished hospitalized subjects for better intervention.
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References
The Prague Declaration: stop disease-related malnutrition. Available at: http://www.european-nutrition.org/index.php/topics/prague. [Accessed 4 March 2018].
Korfalii G, Guündogdu H, Aydintg S, Bahar M, Besler T, Moral AR et al. Nutritional risk of hospitalized patients in Turkey. Clin Nutr 2009; 28: 533–537.
Kruizenga H, Van Keeken S, Weijs P, Luc B, Sandra B, Getty H et al. Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. Am J Clin Nutr 2016; 103:1026–1032.
Budzyński J, Tojek K, Czerniak B, Zbigniew B. Scores of nutritional risk and parameters of nutritional status assessment as predictors of in-hospital mortality and readmissions in the general hospital population. Clin Nutr 2016; 35: 1464–1471.
Lim SL, Ong KC, Chan YH, Oke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr 2012; 31: 345–350.
Löser C. Malnutrition in hospital: the clinical and economic implications. Dtsch Arztebl Int 2010; 107: 911–917.
Corkins MR, Guenter P, DiMaria-Ghalili RA, Gordon L, Ainsley M, Sarah M et al. Malnutrition diagnoses in hospitalized patients. J Parenter Enteral Nutr 2014; 38: 186–195.
Todorovic V, Russell C, Stratton R, Ward J, Elia M. The ‘MUST’ explanatory booklet. 1st ed. Redditch: BAPEN; 2003.
Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr 2005; 82: 1074–1081.
Rabito EI, Marcadenti A, da Silva Fink J, Figueira L, Silva FM. Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service. Nutr Clin Pract 2017; 23:526–532.
Vashi PG, Gupta D, Lammersfeld C, Braun D, Popiel B, Misra S et al. The relationship between baseline nutritional status with subsequent parenteral nutrition and clinical outcomes in cancer patients undergoing hyperthermic intraperitoneal chemotherapy. Nutr J 2013; 12: 118.
Smith RE. The clinical and economic burden of anemia. Am J Manag Care 2010; 16: S59–S66.
IBM. Corp. IBM SPSS Statistics for Windows (Version 21.0.). Armonk, NY: IBM Corp; 2012.
World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310:2191–2194
Starke J, Schneider H, Alteheld B, Stehle P, Meier R. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194–201.
Álvarez-Hernández J, Planas Vila M, León-Sanz M, García de Lorenzo A, Celaya-Pérez S, García-Lorda P et al.; PREDyCES researchers. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES Study. Nutr Hosp 2012; 27:1049–1059.
Kubrack C, Jensen L. Malnutrition in acute care patients. Int J Nurs 2007; 44: 1036–1054.
Raslan M, Gonzalez MC, Dias MC, Nascimento M, Castro M, Margues P et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients. Nutrition 2010; 26: 721–726.
Zhang L, Wang X, Huang Y, Gao Y, Peng N, Zhu W et al. Nutrition Day 2010 audit in Jinling hospital of China. Asia Pac J Clin Nutr 2013; 22: 206–213.
Philipson T, Thornton Sinder J, Lakdawalla D, Stryckman B, Goldman D. Impact of oral nutritional supplementation on hospital outcomes. Am J Manag Care 2017; 19: 121–128.
Nițescu M, Furtunescu FL, Pițigoi D, Streinu-Cercel A, Săndulescu O, Oțelea MR et al. Screening for malnutrition risk at hospital admission in patients with infectious diseases. J Contemp Clin Pract 2017; 3: 57–63.
Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S et al. Nutrition care practises in hospital wards: results from the Nutrition Care Day Survey 201. Clin Nutr 2012; 31: 995–1001.
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Behiry, M.E., Salem, M.R. High prevalence of malnutrition among hospitalized patients in a tertiary care hospital by using malnutrition universal screening tool. Egypt J Intern Med 31, 326–331 (2019). https://doi.org/10.4103/ejim.ejim_126_18
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DOI: https://doi.org/10.4103/ejim.ejim_126_18