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Risk, prevalence, and impact of hospital malnutrition in a Tertiary Care Referral University Hospital: a cross-sectional study

  • Concetta Finocchiaro
  • Giovanni Fanni
  • Simona Bo
IM - COMMENTARY
  • 45 Downloads

Malnutrition is a high-impact condition in terms of public health. Hospital malnutrition (i.e., malnutrition in a healthcare setting) has been demonstrated to affect several major clinical outcomes, such as immune competence, wound healing, quality of life, risk of hospital infections, length of stay, risk of readmission, overall survival, and to be a striking economic burden for the health care system [1, 2, 3, 4, 5, 6]. Up until the present time, hospital malnutrition has a high prevalence rate all over the world that varies from 5 to 60% according to patients’ clinical conditions, geographical region, healthcare setting or hospital department and, remarkably, diagnosis criteria [1, 2, 3, 4, 5, 6, 7]. A gap between the number of patients screened and diagnosed with malnutrition, receiving nutritional recommendations and those effectively malnourished remains much higher [8]. Indeed, sparse awareness and a low attention to this issue are present among healthcare professionals and...

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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References

  1. 1.
    Norman K, Pichard C, Lochs H, Pirlich M (2008) Prognostic impact of disease-related malnutrition. Clin Nutr 27:5–15.  https://doi.org/10.1016/j.clnu.2007.10.007 CrossRefPubMedGoogle Scholar
  2. 2.
    Agarwal E, Ferguson M, Banks M et al (2013) Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: results from the nutrition care day survey 2010. Clin Nutr 32:737–745.  https://doi.org/10.1016/j.clnu.2012.11.021 CrossRefPubMedGoogle Scholar
  3. 3.
    Tobert CM, Mott SL, Nepple KG (2018) Malnutrition diagnosis during adult inpatient hospitalizations: analysis of a multi-institutional collaborative database of academic medical centers. J Acad Nutr Diet 118:125–131.  https://doi.org/10.1016/j.jand.2016.12.019 CrossRefPubMedGoogle Scholar
  4. 4.
    Cereda E, Pedrolli C, Klersy C et al (2016) Nutritional status in older persons according to healthcare setting: a systematic review and meta-analysis of prevalence data using MNA®. Clin Nutr 35:1282–1290.  https://doi.org/10.1016/j.clnu.2016.03.008 CrossRefPubMedGoogle Scholar
  5. 5.
    Barker LA, Gout BS, Crowe TC (2011) Hospital malnutrition: prevalence, identification and impact on patients and the healthcare system. Int J Environ Res Public Health 8:514–527.  https://doi.org/10.3390/ijerph8020514 CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Lim SL, Ong KCB, Chan YH et al (2012) Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr 31:345–350.  https://doi.org/10.1016/j.clnu.2011.11.001 CrossRefPubMedGoogle Scholar
  7. 7.
    Khalatbari-Soltani S, Marques-Vidal P (2015) The economic cost of hospital malnutrition in Europe: a narrative review. Clin Nutr ESPEN 10:e89–e94.  https://doi.org/10.1016/j.clnesp.2015.04.003 CrossRefPubMedGoogle Scholar
  8. 8.
    Sherry CL, Sauer AC, Thrush KE (2017) Assessment of the nutrition care process in US Hospitals using a web-based tool demonstrates the need for quality improvement in malnutrition diagnosis and discharge care. Curr Dev Nutr 1:e001297.  https://doi.org/10.3945/cdn.117.001297 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Lennard-Jones JE, Arrowsmith H, Davison C et al (1995) Screening by nurses and junior doctors to detect malnutrition when patients are first assessed in hospital. Clin Nutr 14:336–340.  https://doi.org/10.1016/S0261-5614(95)80050-6 CrossRefPubMedGoogle Scholar
  10. 10.
    Singh H, Watt K, Veitch R et al (2006) Malnutrition is prevalent in hospitalized medical patients: are housestaff identifying the malnourished patient? Nutrition 22:350–354.  https://doi.org/10.1016/j.nut.2005.08.009 CrossRefPubMedGoogle Scholar
  11. 11.
    Feinberg J, Nielsen EE, Gluud C et al (2015) Nutrition support in hospitalised adults at nutritional risk. Cochrane Database Syst Rev 2015:CD011598. https://doi.org/10.1002/14651858.CD011598 CrossRefGoogle Scholar
  12. 12.
    Muscaritoli M, Krznarić Z, Singer P et al (2017) Effectiveness and efficacy of nutritional therapy: a systematic review following Cochrane methodology. Clin Nutr 36:939–957.  https://doi.org/10.1016/j.clnu.2016.06.022 CrossRefPubMedGoogle Scholar
  13. 13.
    Cederholm T, Barazzoni R, Austin P et al (2017) ESPEN guidelines on definitions and terminology of clinical nutrition. Clin Nutr 36:49–64.  https://doi.org/10.1016/j.clnu.2016.09.004 CrossRefPubMedGoogle Scholar
  14. 14.
    Rinninella E, Cintoni M, De Lorenzo A et al (2018) May nutritional status worsen during hospital stay? A sub—group analysis from a cross—sectional study. Intern Emerg Med.  https://doi.org/10.1007/s11739-018-1944-5 CrossRefPubMedGoogle Scholar
  15. 15.
    Zhu MW, Wei JM, Chen W et al (2018) Dynamic investigation of nutritional risk in patients with malignant tumor during hospitalization. Zhonghua Yi Xue Za Zhi 98:1093–1098.  https://doi.org/10.3760/cma.j.issn.0376-2491.2018.14.009 CrossRefPubMedGoogle Scholar
  16. 16.
    Mosselman MJ, Kruitwagen CLJJ, Schuurmans MJ, Hafsteinsdóttir TB (2013) Malnutrition and risk of malnutrition in patients with stroke: Prevalence during hospital stay. J Neurosci Nurs 45:194–204.  https://doi.org/10.1097/JNN.0b013e31829863cb CrossRefPubMedGoogle Scholar
  17. 17.
    Correia MITD, Perman MI, Waitzberg DL (2017) Hospital malnutrition in Latin America: a systematic review. Clin Nutr 36:958–967.  https://doi.org/10.1016/j.clnu.2016.06.025 CrossRefPubMedGoogle Scholar
  18. 18.
    Cederholm T, Bosaeus I, Barazzoni R et al (2015) Diagnostic criteria for malnutrition—an ESPEN consensus statement. Clin Nutr 34:335–340.  https://doi.org/10.1016/j.clnu.2015.03.001 CrossRefPubMedGoogle Scholar
  19. 19.
    van Bokhorst-de van der Schueren MAE, Guaitoli PR, Jansma EP, de Vet HCW, (2014) Nutrition screening tools: does one size fit all? A systematic review of screening tools for the hospital setting. Clin Nutr 33:39–58.  https://doi.org/10.1016/j.clnu.2013.04.008 CrossRefPubMedGoogle Scholar
  20. 20.
    Parsons K, Fraser A, Bauer J, Collins C (2009) Evidence based practice guidelines for the nutritional management of malnutrition in adult patients across the continuum of care. J Dietit Assoc Aust 66:S1–S34.  https://doi.org/10.1111/j.1747-0080.2009.01383.x CrossRefGoogle Scholar
  21. 21.
    Zhang Z, Pereira SL, Luo M, Matheson EM (2017) Evaluation of blood biomarkers associated with risk of malnutrition in older adults: a systematic review and meta-analysis. Nutrients 9:829CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Player EL, Morris P, Thomas T et al (2018) Bioelectrical impedance analysis (BIA)-derived phase angle (PA) is a practical aid to nutritional assessment in hospital in-patients. Clin Nutr.  https://doi.org/10.1016/j.clnu.2018.08.003 CrossRefPubMedGoogle Scholar
  23. 23.
    Lukaski HC, Kyle UG, Kondrup J (2017) Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: phase angle and impedance ratio. Curr Opin Clin Nutr Metab Care 20:330–339.  https://doi.org/10.1097/MCO.0000000000000387 CrossRefPubMedGoogle Scholar
  24. 24.
    Keller H, Allard J, Vesnaver E et al (2015) Barriers to food intake in acute care hospitals: a report of the Canadian Malnutrition Task Force. J Hum Nutr Diet 28:546–557.  https://doi.org/10.1111/jhn.12314 CrossRefPubMedGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna 2018

Authors and Affiliations

  • Concetta Finocchiaro
    • 1
  • Giovanni Fanni
    • 2
  • Simona Bo
    • 2
  1. 1.Unit of Clinical Nutrition, Hospital of TurinCittà della Salute e della ScienzaTurinItaly
  2. 2.Department of Medical SciencesUniversity of TurinTurinItaly

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