scholarly journals Cribado de la desnutrición hospitalaria en la admisión: la desnutrición aumenta la mortalidad y la duración de la estancia hospitalaria

2017 ◽  
Vol 34 (4) ◽  
Author(s):  
Elisabet Leiva Badosa ◽  
Maria Badia Tahull ◽  
Núria Virgili Casas ◽  
Gema Elguezabal Sangrador ◽  
Concepción Faz Méndez ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Critical Care ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Screening Tests ◽  
Severe Malnutrition ◽  
Critical Care Units ◽  
Factors Associated ◽  
Oncologic Patients

Introduction: Malnutrition is common in patients admitted to hospital and is associated with morbidity and mortality. We conducted a study to assess the prevalence of nutritional risk, risk factors associated and its consequences in a third-level hospital.Methods: This is a prospective nutritional screening study of hospitalized patients evaluated within the first 72 hours of admission, by Malnutrition Universal Screening Tool (MUST) and Short Nutritional Assessment Questionnaire (SNAQ) screening tests. The variables recorded included demographic, anthropometric, hospitalization and clinical data.Results: Out of 409 patients, 12.7% and 15.3% were nutritionally at risk according to MUST and SNAQ, respectively, with the highest prevalence in critical care units (33.3%; 25.5%), amongst oncologic patients (17.5%; 28.4%) and those with higher Charlson Comorbidity Indices (CCI). Length of stay (LOS) was longer in patients at severe malnutrition risk (15.4 vs 9.9 days for MUST; 13.3 vs 9.9 days for SNAQ). Mortality was higher in those with high malnutrition risk (66.7% vs 10.9% for MUST; 50.0% vs 14.2% for SNAQ). Multivariate analysis showed that malnutrition was associated with CCI and mortality. Risk factors associated with LOS were admission as emergencies for both MUST and SNAQ tests. Conclusions: The prevalence of malnutrition is high in patients on admission to a third-level hospital, with a higher prevalence in critical care units, amongst oncologic patients and those with a higher CCI. Malnutrition is associated with longer LOS and higher mortality. The systematic clinical use of screening tools enables to detect patients at risk of malnutrition and take appropriate action.

scholarly journals Nutrition Screening, Reported Dietary Intake, Hospital Foods, and Malnutrition in Critical Care Patients in Malawi

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1170
Author(s):  
Grace C. Barcus ◽  
Peggy C. Papathakis ◽  
Andrew Schaffner ◽  
Bernadette Chimera
Keyword(s):  
Critical Care ◽  
Dietary Intake ◽  
Low Income ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Low Income Countries ◽  
Severe Malnutrition ◽  
Nutrition Screening ◽  
Hospital Malnutrition ◽  
Few Data

In low-income countries there are few data on hospital malnutrition. Reduced food intake combined with nutrient-poor foods served in hospitals contribute to nutritional risk. This study investigated whether reported dietary intake and disease state of hospitalized adults in critical care units was related to malnutrition determined by mid-upper arm circumference (MUAC). Adult in-patients (n = 126) in tuberculosis, burn, oncology, and intensive care units in two public tertiary hospitals in Malawi were screened for nutritional status using MUAC and a question on current dietary intake. The hospital menu was reviewed; portion sizes were weighed. The prevalence of moderate and severe malnutrition was 62%. Patients with organ-related diseases and infectious diseases had the highest rates of reduced reported dietary intake, 71.4% and 57.9%, respectively; however, there was no association between reported dietary intake and MUAC. In those unable to eat, however, the rate of severe malnutrition was 50%. The menu consisted of porridge and thickened corn-based starch with fried cabbage; protein foods were provided twice weekly. There was a nutrient gap of 250 calories and 13 gm protein daily. The findings support the need for increasing dietetic/nutrition services to prevent and treat malnutrition in hospitals using simple screening tools.

scholarly journals Picture Perfect Pups: How Do Attributes of Photographs of Dogs in Online Rescue Profiles Affect Adoption Speed?

Animals ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 152 ◽  
Author(s):  
Mizuho Nakamura ◽  
Navneet Dhand ◽  
Bethany Wilson ◽  
Melissa Starling ◽  
Paul McGreevy
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Natural Environment ◽  
Factors Associated ◽  
Lengths Of Stay ◽  
The Creation ◽  
Labrador Retrievers ◽  
Selection Of

To increase the public’s awareness of and exposure to animals needing homes, PetRescue, Australia’s largest online directory of animals in need of adoption, lists all currently available animals from rescue and welfare shelters nationwide. The current study examined the photographs in the PetRescue online profiles of the three most common breeds within these data, namely, Staffordshire bull terriers (n = 3988), Labrador retrievers (n = 2246), and Jack Russell terriers (n = 2088), to identify the inferred preferences of potential adopters. By investigating the attributes of these photographs, we were able to identify visual risk factors associated with protracted lengths of stay (LOS). The longest stays were associated with dogs with erect ears and those photographed in a natural environment, i.e., 18.32 days and 19.57 days, respectively. Dogs photographed in a kennel and with mouths closed had the shortest LOS, i.e., 11.54 d and 14.44 d, respectively. Heightened awareness of the roles of photographic attributes in generating interest among potential adopters may increase the speed of adoption by guiding the creation of online profiles and selection of photos to optimise the promotion of dogs at risk of long stays.

scholarly journals A quality improvement project for delirium prevention and management over the Greater Manchester Critical Care Network

2020 ◽  
pp. 175114372091270
Author(s):  
Jessica Davis ◽  
Karen Berry ◽  
Rebecca McIntyre ◽  
Daniel Conway ◽  
Anthony Thomas ◽  
...  
Keyword(s):  
Critical Care ◽  
Best Practice ◽  
Point Prevalence ◽  
Screening Tools ◽  
Care Bundle ◽  
Improvement Project ◽  
Care Network ◽  
Critical Care Units ◽  
Patient Morbidity ◽  
Delirium Prevention

Background Delirium is a common complication of critical illness with a significant impact on patient morbidity and mortality. The Greater Manchester Critical Care Network established the Delirium Reduction Working Group in 2015. This article describes a region-wide delirium improvement project launched by that group. Methods Multiple Plan-Do-Study-Act cycles were undertaken. Cycle 1: April 2015 demonstrated only 48% of patients had a formal delirium screen. Following this a network-wide event took place and the Delirium Standards for the Greater Manchester Critical Care Network were produced. Cycle 2: May 2016 quarterly audits across the network monitored compliance against the agreed standards. Group events involved implementation of a delirium care bundle, sharing best practice, educating staff and providing guidance on the management of delirium. Cycle 3: November 2016 quarterly audit continued and a regional delirium study day was rolled out across the region. Results We have 14 different units across our network, all of which have participated in the audit. The first audit showed a delirium point prevalence of 28%, subsequent point prevalence audits demonstrated rates as low as 13%. There has also been an improvement in the use of delirium screening tools. In the first audit 37% of patients had two delirium screens in 24 h, this has increased to 60% in the latest audit. Improvements were also made in availability of sensory aids and pain assessments. Conclusion The project has demonstrated the feasibility of delivering a coordinated delirium improvement project across multiple critical care units.

scholarly journals Prevalence and Determinants of Undernutrition in A Sample of Dutch Community-Dwelling Older Adults: Results from Two Online Screening Tools

2019 ◽  
Vol 16 (9) ◽  
pp. 1562 ◽  
Author(s):  
Jos W. Borkent ◽  
Elke Naumann ◽  
Emmelyne Vasse ◽  
Ellen van der Heijden ◽  
Marian A. E. de van der Schueren
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Healthy Aging ◽  
General Information ◽  
Community Dwelling ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Cross Sectional ◽  
Increased Risk ◽  
Screen Ii

To stimulate undernutrition screening among Dutch community-dwelling adults, a website was developed with general information on healthy eating for healthy aging and self-tests. Based on cross-sectional data obtained from the self-tests, we studied nutritional risk factors (early determinants) as well as risk of undernutrition (late symptoms). SCREEN II (n = 2470) was used to asses nutritional risk factors. This tool consists of 16 items regarding nutritional intake, perception of body weight, appetite, oral health and meal preparation. An adjusted SNAQ65+ (n = 687) was used to assess risk of undernutrition. This four-item tool contains questions on weight loss, appetite, walking stairs and body mass index. Differences between age-groups (65–74, 75–84, ≥85) were tested by logistic regression. Overall prevalence of nutritional risk factors was 84.1%, and increased risk of undernutrition was 56.8%. Participants aged ≥85 scored worst on almost all items of the SCREEN II and the SNAQ65+. In conclusion: A large proportion of older adults reported early determinants for increased nutrition risk, while a smaller, yet remarkable proportion scored positive on undernutrition risk. Internet screening may be a useful, contemporary, and easy, accessible way to reach older adults who are at nutritional risk and may thus contribute to early identification and prevention of undernutrition.

scholarly journals Risk factors associated with development and persistence of long COVID

2021 ◽  
Author(s):  
Yusuke Miyazato ◽  
Shinya Tsuzuki ◽  
Shinichiro Morioka ◽  
Mari Terada ◽  
Satoshi Kutsuna ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Linear Regression Analysis ◽  
Patient Characteristics ◽  
Cross Sectional ◽  
Residual Symptoms ◽  
Factors Associated ◽  
Mild Disease ◽  
Number Of Patients ◽  
Low Body Mass Index

Background Long COVID has been a social concern. Though patient characteristics associated with developing long COVID are partially known, those associated with persisting it have not been identified. Methods We conducted a cross-sectional questionnaire survey of patients after COVID-19 recovery who visited the National Center for Global Health and Medicine between February 2020 and March 2021. Demographic and clinical data, and the presence and duration of long COVID were obtained. We identified factors associated with development and persistence of long COVID using multivariate logistic and linear regression analysis, respectively. Results We analyzed 457 of 526 responses (response rate, 86.9%). The median age was 47 years, and 378 patients (84.4%) had mild disease in acute phase. The number of patients with any symptoms after 6 and 12 months after onset or diagnosis were 120 (26.3%) and 40 (8.8%), respectively. Women were at risk for development of fatigue (OR 2.03, 95% CI 1.31-3.14), dysosmia (OR 1.91, 95% CI 1.24-2.93), dysgeusia (OR 1.56, 95% CI 1.02-2.39), and hair loss (OR 3.00, 95% CI 1.77-5.09), and were at risk for persistence of any symptoms (coefficient 38.0, 95% CI 13.3-62.8). Younger age and low body mass index were risk factors for developing dysosmia (OR 0.96, 95% CI 0.94-0.98, and OR 0.94, 95% CI 0.89-0.99, respectively) and dysgeusia (OR 0.98, 95% CI 0.96-1.00, and OR 0.93, 95% CI 0.88-0.98, respectively). Conclusion We identified risk factors for the persistence as well as development of long COVID. Many patients suffer from long-term residual symptoms, even in mild cases.

scholarly journals Nutritional interventions among old people receiving support at home

2018 ◽  
Vol 77 (3) ◽  
pp. 265-269 ◽  
Author(s):  
Anne Marie Beck
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Multidisciplinary Approach ◽  
Screening Tools ◽  
Nutritional Risk ◽  
Old People ◽  
Nutritional Interventions ◽  
Care Costs ◽  
At Home

With the focus of care shifting from the hospital to the community, supportive nutritional care to old people is to become an important issue to address in the community, since undernutrition has serious consequences, both for the quality of life and for the health care costs. Several modifiable nutritional risk factors relate to undernutrition. Unfortunately, the problem with (risk of) undernutrition is aggravated due to a lack of alertness among e.g. health care staff, leading to insufficient attention for systemic screening and nutritional care. Only a few of the existing screening tools have been validated among old people receiving support at home. Few studies have assessed the beneficial effect of nutritional support among old people in their own home, and recently, it was concluded that such have shown limited effects. One reason may be that the nutritional interventions performed have not taken the multiple nutritional risk factors afore-mentioned into consideration when formulating the action/treatment plan and hence not used a multidisciplinary approach. Another reason may be that the intervention studies have not used validated screening tools to identify those old people most likely to benefit from the nutritional support. However, three recent studies have used a multidisciplinary approach and two have proven a beneficial effect on the quality of life of the old people and the health care costs. These findings suggest that when planning nutritional intervention studies for old people receiving support at home, modifiable nutritional risk factors should be taken into consideration, and a multidisciplinary approach considered.

scholarly journals Nutritional risk amongst community-living Maori and non-Maori older people in Hawke’s Bay

2012 ◽  
Vol 4 (4) ◽  
pp. 299 ◽  
Author(s):  
Caroline McElnay ◽  
Bob Marshall ◽  
Jessica O’Sullivan ◽  
Lisa Jones ◽  
Tracy Ashworth ◽  
...  
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Nutritional Status ◽  
Older People ◽  
Nutritional Risk ◽  
Community Living ◽  
Milk Product ◽  
Living Situation ◽  
Good Nutrition ◽  
Poor Nutrition

INTRODUCTION: Maintaining good nutrition is vital for healthy ageing. Poor nutrition increases the risk of hospitalisation, disability and mortality. Research shows clinical malnutrition is preceded by a state of nutritional risk and screening can identify older people at risk of poor nutrition or who currently have impaired nutritional status. AIM: To assess the population prevalence of nutritional risk amongst community-living Maori and non-Maori older people in Hawke’s Bay. METHODS: A postal survey of 1268 people aged 65 years or older on the electoral roll for Hawke’s Bay was conducted. Nutritional risk was measured using the SCREEN II questionnaire. RESULTS: Responses from 473 people were received (43.8% male, 49.9% female, 6.3% unspecified) with an estimated average age of 74 years. Nutritional risk was present amongst 56.5% of older people with 23.7% at risk and 32.8% at high risk. Maori were 5.2 times more likely to be at nutritional risk than non-Maori. Older people living alone were 3.5 times more likely to be at nutritional risk than those living with others. The most frequent risk factors were low milk-product intake, perception of own weight being more or less than it should be, and low meat and alternatives intake. Skipping meals and low fruit and vegetable intake were additional frequent risk factors for Maori. DISCUSSION: Both living situation and ethnicity are associated with nutritional risk. Further investigation is needed to confirm these findings and to determine issues specific for older Maori, including barriers to good nutrition and opportunities for nutritional improvement. KEYWORDS: Maori; nutritional status; older people

Caseous lymphadenitis in small ruminants in Egypt

2014 ◽  
Vol 42 (05) ◽  
pp. 271-277 ◽  
Author(s):  
A. F. Oreiby ◽  
Y. M. Hegazy ◽  
Y. M. Ghanem ◽  
M. H. Al-Gaabary ◽  
S. A. Osman
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Close Contact ◽  
Small Ruminants ◽  
Breeding Systems ◽  
Caseous Lymphadenitis ◽  
Factors Associated ◽  
Short Period ◽  
Antibody Titers

Summary Objective: The aim of this study was to investigate the distribution of caseous lymphadenitis (CLA) among small ruminants in Egypt, identify risk factors associated with its occurrence and to analyze the efficacy of the vaccine for control of CLA. Material and methods: A total of 1206 sheep and 351 goats were examined clinically for CLA. The prevalence and the risk factors of CLA in small ruminant flocks were estimated and identified. Efficacy of the commercial vaccine Case-Bac (Colorado Serum Company, USA) was determined in a field study trial conducted on 15 CLA-free lambs. Follow-up of vaccination immune response was carried out using indirect ELISA. Results: Prevalence of superficial CLA was 6.7%. Clinically, CLA appeared as abscesses in superficial lymph nodes mostly of the head and neck. On the basis of a multivariate analysis which accounted for clustering at herd level, sheep were at risk of getting superficial CLA 3.5 times more than goats (p < 0.0001). Animals of fixed flocks were at risk of getting the superficial CLA 2 times more than animals in fixed-mobile flocks (p < 0.038). Serological follow-up indicated protective antibody titers for 6 months. In vaccinated animals clinical cases were not observed while they occurred among non-vaccinated sheep. Discussion: Prevalence of CLA varied among studied flocks even between those of the same breeding system due to complex and overlapping factors associated with each flock like introduction or culling rate of animals, care of shepherds or owners to deal with opened abscesses in addition to the average age of the animals within each flock. Breeding systems have observable effects on occurrence of CLA: infected sheep can transmit the infection to a large number of animals in a short period under the conditions of close contact and reduced air flow in covered sheds. Conclusion and clinical relevance: Infected small ruminants in fixed flocks represent a risk factor for CLA for healthy ones. The vaccine used in the study provides an effective protection against new in fections. So mass vaccination of small ruminants against CLA in Egypt has to be considered to minimize the disease prevalence.

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