Malnutrition in hospitalized patients: results from La Rioja

Ángela Martín Palmero, Andra Serrano Pérez, Mª José Chinchetru Ranedo, Alejandro Cámara Balda, Mª Ángeles Martínez de Salinas Santamarí, Gonzalo Villar García, Mª del Mar Marín Lizárraga

Resumen


Background: There is a high malnutrition prevalence in hospitalized patients. Aim: To determine the malnutrition prevalence in hospitalized patients of La Rioja Community (Spain) when evaluated with different screening/ evaluation tools and its relationship with hospital stay and mortality.

Methods: Cross sectional observational study of hospitalized adult patients (age > 18 years old) from medical and surgical departments that underwent within 72 h of their admission a nutritional screening with Malnutrition Universal Screening Tool (MUST), Nutritional Risk Screening (NRS) 2002, Controlling Nutritional Status (CONUT) y Subjective Global Assessment (SGA).

Results: 384 patients (273 medical and 111 surgical) were evaluated. Almost fifty percent of them were considered malnourished independently of the screening/assessment tool used. High concordance was found between SGA and NRS-2002 (k = 0.758). Malnourished patients had a longer hospital stay than those well-nourished (9.29 vs. 7.10 days; p = 0.002), used a greater number of medicines (9.2 vs. 7.4; p = 0.001) and underwent a higher number of diagnostic tests (16.4 vs. 12.5; p = 0,002).

Conclusions: Half of the hospitalized patients in the medical and surgical department of La Rioja are malnourished. This is associated with a longer hospital stay, higher use of medicines, diagnostics tests and greater mortality. Malnutrition could be detected with easy screening tools to treat it appropriately.


Palabras clave


Hospital malnutrition. Nutritional status. Nutritional screening. Nutritional assessment.

Texto completo:

PDF (English)

Referencias


Butterworth C. The skeleton in the hospital closet. Nutrition Today. 1974;9:4-8.

Bristian BR, Blackburn GL, Hallowell E, Heddle R. Protein status on general surgical patients. JAMA 1974; 230: 858-860.

Bristian BR, Blackburn GL, Vitale J, Cochran D, Naylor J. Prevalence of malnutrition in general medical patients. JAMA 1976; 235: 1567-1570.

Pérez de la Cruz A, Lobo Tamer G, Orduna Espinosa R, Mellado Pastor C, Aguayo de Hoyos E, Ruiz Lopez MD. [Malnutrition in hospitalized patients: prevalence andeconomic impact]. Med Clin (Barc) 2004; 123: 201-6.

De Luis D, López Guzmán A. Nutritional status of adult patients admitted to internal medicine departments in public hospitals in Castilla y Leon, Spain - A multi-centre study. Eur J Intern Med 2006; 17: 556-60.

Planas M, Audivert S, Pérez-Portabella C, Burgos R, Puiggrós C, Casanelles JM, Rosselló J. Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genoma. Clin Nutr 2004; 23: 1016-24.

Martínez Olmos MA, Martínez Vázquez MJ, Martínez-Puga E, el Campo Pérez V. Nutritional status study of inpatients in hospitals of Galicia. Eur J Clin Nutr 2005; 59: 938-46.

Sanz Paris et al. Malnutrition prevalence in hospitalized elderly diabetic patients. Nutr Hosp. 2013;28(3):592-599

Sullivan DH, Sun S, et al. Protein-energy undernutrition among elderly hospitalized patients: a prospective study. JAMA. 1999;281:2013-2019.

Correia MI, Campos AC; ELAN Cooperative Study. Prevalence of hospi- tal malnutrition in Latin America: the multicenter ELAN study. Nutrition. 2003;19:823-825.

Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr 2008;27:5e15.

Kirkland LL, Kashiwagi DT, Brantley S, et al. Nutrition in the hospitalized patient. J Hosp Med 2013;8:52e58.

Charlton KE, Nichols C, Bowden S, et al. Older rehabilitation patients are at high risk of malnutrition: Evidence from a large Australian database. J Nutr Health Aging 2010;14:622e628.

Agarwal E, Ferguson M, Banks M, et al. Nutritional status and dietary intake of acute care patients: Results from the Nutrition Care Day Survey 2010. Clin Nutr 2012;31:41e47.

Zhang L, Wang X, Huang Y, et al. NutritionDay 2010 audit in Jinling hospital of China. Asia Pac J Clin Nutr 2013;22:206e213.

Schneider SM, Veyres P, Pivot X, et al. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr 2004;92:105e111.

Bauer JD, Isenring E, Torma J, et al. Nutritional status of patients who have fallen in an acute care setting. J Hum Nutr Diet 2007;20:558e564.

Fry DE, Pine M, Jones BL, Meimban RJ. Patient characteristics and the occurrence of never events. Arch Surg 2010;145:148e151.

Lim SL, Ong KC, Chan YH, et al. Malnutrition and its impact on cost of hospi- talization, length of stay, readmission and 3-year mortality. Clin Nutr 2012;31: 345e350.

Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality,length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003;22:235e239.

Freijer K, Tan SS, Koopmanschap MA, et al. The economic costs of disease related malnutrition. Clin Nutr 2013;32:136e141.

Cawood AL, Elia M, Stratton RJ. Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev 2012;11: 278e296.

MilneAC,PotterJ,VivantiA,AvenellA.Proteinandenergysupplementationin elderly people at risk from malnutrition. Cochrane Database Syst Rev; 2009:CD003288.

Starke J, Schneider H, Alteheld B, et al. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011;30:194e201.

Philipson TJ, Snider JT, Lakdawalla DN, et al. Impact of oral nutritional sup- plementation on hospital outcomes. Am J Manag Care 2013;19:121e128.

Stratton RJ, Hebuterne X, Elia M. A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions. Ageing Res Rev 2013;12:884e897.

Janice Sorensen et al. EuroOOPS: An international, multicenter study to implement nutritional risk cribado and evaluate clinical outcome. Clin Nutr 2008; 27: 340-349

Corkins et al. Malnutrition Diagnoses in Hospitalized Patients: United States, 2010. JPEN 2014;38(2): 186-195

Schenker S. Undernutrition in the UK. Nutr Bull 2003;28:87e120.

J. Alvarez-Hernandez et al. Prevalence and costs of malnutritiona in hospitalized patients; the PREDyCES Study (Nutr Hosp. 2012;27:1049-1059)

Commission of the European Communities. “Together for health: a Strategic Approach for the EU 2008-2013”. (Accessed November 25, 2010 at http://ec.europa.eu/health/strategy/ policy/index_en.htm).

Jeejebohoy KN. Nutritional assesment. Nutrition 2000; 16: 585-590

L.Gonzalez Castela et al: Nutr Hosp 2001, 16:7-13

Russell A, Elia M on behalf of British Association for Parenteral and Enteral Nutrition (BAPEN). Nutrition Cribado Survey in the UK and Republic of Ireland 2010 British Association for Parenteral and Enteral Nutrition (BAPEN) www.bapen.org Accessed Jan. 24, 2013.

Vanderwee K, Clays E, Bocquaert I, Gobert M, Folens B, Defloor T. Malnutrition and associated factors in elderly hospital patients: A Belgian cross-sectional, multi-centre study. Clin Nutr 2010; 29: 469-76.

Malnutrition in Dutch health care: prevalence, prevention, treatment, and quality indicators.Meijers JM, Halfens RJ, van Bokhorst-de van der Schueren MA, Dassen T, Schols JM.Nutrition. 2009 May; 25(5):512-9. Epub 2009 Jan 9.

Pirlich M, Schutz T, Norman K, Gastell S, Lubke HJ, Bischoff SC et al. The German hospital malnutrition study. Clin Nutr 2006; 25: 563-72.

Ursula G.Kyle and col. Hospital leght of stay and nutritional status.Curr Opin Clin Nutr Metab Care 2005, 8:397:402




DOI: http://dx.doi.org/10.20960/nh.458

Enlaces refback

  • No hay ningún enlace refback.