scholarly journals Hospital Malnutrition, Nutritional Risk Factors, and Elements of Nutritional Care in Europe: Comparison of Polish Results with All European Countries Participating in the nDay Survey

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 263
Author(s):  
Joanna Ostrowska ◽  
Isabella Sulz ◽  
Silvia Tarantino ◽  
Michael Hiesmayr ◽  
Dorota Szostak-Węgierek
Keyword(s):  
Risk Factors ◽  
Food Intake ◽  
Reference Group ◽  
Hospitalized Patients ◽  
European Countries ◽  
Nutritional Risk ◽  
Care Process ◽  
Nutritional Care ◽  
Hospital Malnutrition ◽  
Hospital Wards

NutritionDay (nDay) is a project established by the Medical University of Vienna and the European Society for Clinical Nutrition and Metabolism (ESPEN) to audit the nutritional status of hospitalized patients and nursing home residents. This study aimed to evaluate nDay data describing the prevalence of hospital malnutrition, nutritional risk factors, and elements of the nutritional care process implemented in hospital wards in 25 European countries and to compare the data derived from Poland with the data collected in all the European countries participating in the study. In total, 10,863 patients (European reference group: 10,863 participants including Poland: 498 participants) were involved in the study. The prevalence of malnutrition was identified on the basis of the ESPEN diagnostic criteria established in 2015, while the prevalence of nutritional risk factors was assessed by analyzing the following parameters: body mass index (BMI), score of Malnutrition Screening Tool (MST), recent weight loss, insufficient food intake, decreased appetite, increased number of drugs intake, reduced mobility, and poor self-reported health status. Malnutrition prevalence was 12.9% in patients from the European reference group and 9.4% in patients from Polish hospital wards (p < 0.05). However, the prevalence of some nutritional risk factors, i.e., recent weight loss, history of decreased food intake, and low actual food intake, were approximately four times more prevalent than diagnosed malnutrition (referring to approximately 40–50% of all participants). In comparison to the European reference group, the significant differences observed in Polish hospital wards concerned mainly dietitian’s involvement in the process of treating malnutrition (16% vs. 57.2%; p < 0.001); supply of special diets (8% vs. 16.1%; p < 0.0001); provision of oral nutritional support (ONS) (3.8% vs. 12.2%; p < 0.0001); prescription of enteral/parenteral nutrition therapy to hospitalized patients (8.2% vs. 11.7%; p < 0.001); as well as recording patient weight performed at hospital admission (100% vs. 72.9%; p < 0.0001), weekly (20% vs. 41.4%; p < 0.05), and occasionally (0% vs. 9.2%). These results indicate that the prevalence of malnutrition and malnutrition risk factors in hospitalized patients in Poland was slightly lower than in the European reference group. However, some elements of the nutritional care process in Polish hospitals were found insufficient and demand more attention.

scholarly journals A study of nutritional status, development of malnutrition and food consumption in hospitalized patients

2019 ◽  
Vol 3 (2) ◽  
pp. 66-80
Author(s):  
Anil Evrim Gungor ◽  
Perihan Arslan ◽  
Osman Abbasoglu
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Food Services ◽  
Hospital Malnutrition ◽  
Arm Circumference ◽  
Nrs 2002 ◽  
Mid Upper Arm Circumference ◽  
Nutritional Risk Screening

Purpose: To investigate the nutritional status of patients on admission and during hospital stay, the factors leading to weight loss, and to evaluate patient satisfaction of hospital food. Methods: On admission, Nutritional Risk Screening (NRS-2002), weight, height, Body Mass Index (BMI), mid upper arm circumference (MAC) measurements were carried out; serum total protein and albumin levels were recorded. Upon discharge, measurements of weight, MAC were repeated, along with a food satisfaction questionnaire. Results: Patients with NRS-2002>3, BMI<20, were classified as nutrionally at risk which were 43.6% and 9.4% respectively. Of the patients, 77% lost weight (2.6±1.9 kg). Patients who were determined to be malnourished on admission by BMI and NRS-2002 stayed longer in hospital (p<0.0 and p<0.001, respectively). The relationships between weight loss and lenght of stay, use of medications and period of starvation were significant (p<0.0001, for each). Of the patients, 49.9% did not satisfy with the hospital food. Conclusions: Nutritional status of hospitalized patients should be screened with NRS-2002, assessed and monitored. Keywords: NRS-2002, hospital malnutrition, hospital food services

P150 A STUDY OF HOSPITAL MALNUTRITION AND RELATED NUTRITIONAL RISK FACTORS

2009 ◽  
Vol 4 (2) ◽  
pp. 88-89
Author(s):  
E.A. Gungor ◽  
P. Arslan ◽  
E. Karabulut ◽  
O. Abbasoglu ◽  
M. Halil ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nutritional Risk ◽  
Hospital Malnutrition

scholarly journals The Assessment Of Energy And Protein Needs Coverage In Hospitalized Patients

2016 ◽  
Vol 55 (2) ◽  
pp. 136-143
Author(s):  
Ruža Pandel Mikuš ◽  
Vid Vičič ◽  
Raja Dahmane
Keyword(s):  
Food Intake ◽  
Nutritional Value ◽  
High Strength ◽  
Multivariate Model ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Simple Method ◽  
Energy Needs ◽  
Logistic Regression Method ◽  
Strength Of Association

Abstract Aim Aiming at assessing sufficiency of energy/protein intake in hospitalized patients, the objective was to monitor and analyze actual food intake of patients hospitalized in three clinical wards of one of major Slovenian hospitals. Methods 53 patients were included in the study. Food intake was assessed 3 times daily from leftovers. Nutritional status was assessed with Nutritional Risk Screening tool 2002. The observed outcomes were percentage of energy coverage (PEC) and percentage of protein coverage (PPC). In PEC energy nutritional value of the menu (ENVM), and in PPC protein nutritional value of the menu (PNVM) were considered as the main modifiable risk factors. Data were analyzed univariately and multivariately by using logistic regression method. Results The patients did not cover energy needs (67.4±24.5%). Multivariate model for PEC was highly significant (R2=0.347; pmodel<0.001) with ENVM showing high strength of association (b=0.040; p=0.004). Patients also did not cover protein needs (84.0±40.2%). Multivariate model for PEC was highly significant (R2=0.477; pmodel<0.001) and PNVM showing high strength of association (b=0.937; p=0.002). Conclusion For successful prevention and early detection of malnutrition, food intake in hospitals is vital and should be constantly monitored. A simple method for monitoring is proposed. The menus provided to patients should also be adequate in terms of energy and protein content.

scholarly journals NutriDia Brasil: retrato dos cuidados nutricionais em um hospital de alta complexidade do Rio Grande do Sul

2020 ◽  
Vol 35 (3) ◽  
pp. 216-221
Author(s):  
Marilene Fleck de Oliveira ◽  
Maria Cristina Zanchim ◽  
Carolina Benvenuti de Mattos ◽  
Vanuza Burille ◽  
Tatiana Pacheco Rodrigues ◽  
...  
Keyword(s):  
Weight Loss ◽  
Food Intake ◽  
Quality Care ◽  
Length Of Hospital Stay ◽  
Public Health Problem ◽  
Nutritional Therapy ◽  
Nutritional Risk ◽  
Artificial Nutrition ◽  
Hospital Malnutrition ◽  
Loss Of Appetite

ntroduction: Hospital malnutrition is considered a public health problem, whose prevalence ranges from 40% to 60% on admission, reaching figures of 80% during the course of hospitalization. In this context, the nutriDia Brasil project aims to highlight nutritional problems that hospitalized patients have, as well as resources available for the management and knowledge of health professionals in this regard. Methods: Longitudinal observational study, using data from the multiprofessional nutritional therapy team at Hospital São Vicente de Paulo, in Passo Fundo, RS, an institution participating in nutriDia Brasil, in November 2017. For the composition of the study, variables such as gender, age, diagnosis, length of hospital stay, body mass index (BMI), weight loss, identification of nutritional risk, type of nutritional therapy, acceptance of diet, consumption of food outside the hospital routine and clinical outcome after 30 days. Results: 136 patients were evaluated, with a mean age of 57 ± 3.2 years, most of whom were male (53%). The main causes of hospitalization were diseases of the musculoskeletal system (21.1%), circulatory (15.8%), digestive (13.9%) and genitourinary (10%). Regarding nutritional status, the mean BMI was 25.9 ± 4.8 kg/m² and weight loss was reported in 55% of cases, with an average reduction of 6.7 ± 2.1 kg. 39.2% of those evaluated and only 51.9% managed to ingest the entire hospital diet prescribed. Among the causes of reduced food intake, 13.2% reported symptoms such as nausea or vomiting and 9.1% loss of appetite. 71.3% received an exclusive oral diet; 17.4% used nutritional supplements in combination with hospital foods and 11.3% received artificial nutrition. Conclusion: Weight loss, inadequate food intake and the presence of nutritional deviations were the most relevant factors, suggesting the need to implement improvements that contribute to safe and quality care for the patient.

Nutrition Status, Nutrition Support Therapy, and Food Intake are Related to Prolonged Hospital Stays in China: Results from the NutritionDay 2015 Survey

2016 ◽  
Vol 69 (3-4) ◽  
pp. 215-225 ◽  
Author(s):  
Huijun Zheng ◽  
Yingchun Huang ◽  
Yongmei Shi ◽  
Wei Chen ◽  
Jianchun Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Food Intake ◽  
Hospitalized Patients ◽  
Nutrition Support ◽  
Nutrition Status ◽  
Related Factors ◽  
Oral Nutrition ◽  
The Past ◽  
Hospital Stays ◽  
Prolonged Hospital

Background and Aims: Malnutrition is a common and critical problem that greatly influences the clinical outcomes of hospitalized patients. Nutrition support therapy and food intake, in addition to disease-related factors, are also important to maintain the nutrition status of patients. In light of this, we aimed to examine the risk factors associated with malnutrition in 3 hospitals in China. Methods: This project was part of the NutritionDay audit, an international daylong cross-sectional audit investigating the nutritional intervention profiles of hospitalized patients. Seven standardized questionnaires were used, and malnutrition was defined as a body mass index <18.5 kg/m2 or unintentional weight loss >5% in last 3 months. Results: A total of 842 hospitalized patients from 9 units in 3 Chinese hospitals participated in the project on November 19, 2015. Among them, 825 were included in the analyses. Malnutrition was identified in 29.3% of the patients and oral nutrition was the primary nutrition support therapy administered (n = 623, 75.6%). Age, nutrition support, and food intake during the past week were independent risk factors for malnutrition. Furthermore, nutrition status, nutrition support therapy, and food intake during the past week were associated with prolonged length of stay. Conclusions: The prevalence of malnutrition in Chinese hospitals was similar to that in European hospitals. Nutrition status was associated with age, nutrition support, and food intake, which was closely related to patients' clinical outcome, such as prolonged hospital stays as confirmed in this study. More studies are needed to determine why nutrition intake is often inadequate and to determine efficient methods for correcting the nutrition status of patients.

scholarly journals Are Nutritional Care Adequate for Elderly Hospitalized Patients? A Cross-Sectional Study

SAGE Open ◽  
2016 ◽  
Vol 6 (4) ◽  
pp. 215824401668206 ◽  
Author(s):  
Helene Kjøllesdal Eide ◽  
Jūratė Šaltytė Benth ◽  
Kjersti Sortland ◽  
Kristin Halvorsen ◽  
Kari Almendingen
Keyword(s):  
Elderly Patients ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Nutritional Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutritional Care ◽  
Elderly Hospitalized Patients

This article assesses nutritional care in identifying and treating nutritional risk in elderly hospitalized patients. A cross-sectional study was conducted at a large Norwegian University hospital in the period 2011 to 2013. Data on nutritional risk and care for elderly patients (≥70 years) without dementia were collected at 20 wards by 173 second-year nursing students in acute-care clinical studies. A stratified sampling technique was utilized to improve the representativeness of the sample. In total, 508 patients (48.8% women) with a mean age of 79.6 years participated. The internationally and nationally recommended nutritional care was not implemented at the hospital, suggesting that nutritional care for elderly hospitalized patients was not adequate. This implies that the majority of the elderly patients nutritionally at risk are neither identified nor treated according to their needs. The article highlights the importance of having systematic nutritional care practices to make it possible for the hospital ward staff to routinely identify nutritional risk and initiate appropriate nutritional treatment measures.

scholarly journals Reduced Food Intake Is Associated with Mortality in Hospitalized Patients (P12-026-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Kyungah Chi ◽  
Soyoon Yoon ◽  
Eunhee Kang ◽  
Shinsook Kang ◽  
Yeonmi Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Food Intake ◽  
Mortality Risk ◽  
Large Scale ◽  
Hospitalized Patients ◽  
Nutrition Support ◽  
Related Factors ◽  
Cross Sectional ◽  
Probability Of Death ◽  
Inadequate Food Intake

Abstract Objectives Inadequate food intake is associated with mortality in hospitalized patients. Even with the emphasis on malnutrition-related dangers, investigating all hospitalized patients in Korea for food intake and factors affecting food intake is difficult but we need to food intake in hospitalized patients for efficient nutrition management. Therefore, A large-scale nutrition investigation was conducted to examine food intake in all hospitalized patients. We aimed to examine food intakes in hospitalized patients in Korea, to evaluate the relationship between inadequate food intake and mortality, and to ascertain mortality-related risk factors. Methods A one-day cross-sectional study on food intake and mortality was conducted on 1074 hospitalized adult patients on June 23, 2011. Food intake, assessed using questionnaires, was divided into four categories: 0%, 25%, 50%, and 100%. We collected disease-related factors and meal-related factors from electronic medical records. We also evaluated "length of hospital stay" and "probability of death in hospital" using a post-survey after 60 days. We identified risk factors for mortality using multivariate analysis. Gray's test was adopted for survival analysis of “probability of death in hospital” according to food intake. Results We included 1074 patients from 56 wards, including the intensive care unit. The following characteristics were observed: average age, 57 years; average body mass index, 22.8 kg/m2; and sex ratio, 55.2% male. On survey day, 35.4% patients ate a whole meal, 56.4% ate half of the meal, 20.2% ate quarter of the meal, and 8.2% ate nothing. Patients who consumed nothing had a 7.2-times higher mortality risk (HR) than patients who consumed a whole meal (P = 0.001). The mortality risk increased by 2.9 (P = 0.056) and 2.6 times (P = 0.102) in patients who consumed 50% and 25% of the meal, respectively. Risk factors contributing to mortality risk included heart/circulation (HR 18.026, P = 0.005), cancer (HR 17.990, P < 0.001), decreased consumption than last week (HR 10.120, P = 0.027), weight loss within 3 months (HR 4.820, P = 0.010), walking inability (HR 4.245, P = 0.020), walking only with assistance (HR 3.358, P = 0.010), and myocardial infarction (HR 2.571, P = 0.022). Contrastingly, “nutrition support” resulted in a significantly reduced mortality risk (HR 0.332, P = 0.015). Conclusions Reduced food intake can affect mortality rates in hospitalized patients. Based on factors significantly impacting mortality, patient groups can be selected for intensive nutrition care. Funding Sources none. Supporting Tables, Images and/or Graphs

scholarly journals Determinants and consequences of malnutrition in hospitalized patients at a Norwegian University Hospital

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Marte A. Trollebo ◽  
Ingrid Revheim ◽  
Hanne Rosendahl-Riise ◽  
Mette H. Morken ◽  
Randi J. Tangvik ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Food Intake ◽  
Dietary Habits ◽  
Hospitalized Patients ◽  
Screening Tools ◽  
University Hospital ◽  
Nutritional Risk ◽  
Control Group ◽  
High Degree

AbstractBackground:Malnutrition is a serious condition that is frequent in hospitalized patients even in countries with high healthcare standards, and may affect up to 30% of all hospitalized patients in tertiary hospitals. Malnutrition or risk of malnutrition (hereafter referred to as malnutrition) strongly relate to clinical outcomes and mortality, even after adjustment for age and co-morbidities. There is a great need for improved methods for detecting and treating malnutrition in this population.Objective:Investigate factors that are associated with malnutrition at hospitalization, and provide data on specific nutrient deficiencies that are associated with malnutrition. Analyse the association of malnutrition with nutritional biomarkers, quality of life, disease-related functions and re-hospitalization, morbidity and mortality.Design:The study is s a prospective case-control study including patients from different Departments of a tertiary hospital (Haukeland University Hospital, Bergen, Norway). As part of the patients security programme, all hospitalized patients are routinely screened for nutritional risk using NRS-2002. The result allocates the patient to either the case- or the control group. Included patients undergo extensive examinations; standardized assessments of quality of life, socio-economic status, lifestyle habits, dietary habits and food intake, and anthropometric measurements (mid-upper arm circumference, waist circumference and body composition by bioelectrical impedance analysis). Blood and urine samples are collected to assess nutritional biomarkers related to malnutrition.Results:The study recruitment is ongoing and up to April 2019, 220 patients have been recruited (n = 90 (41%) at nutritional risk, n = 130 (59%) not at nutritional risk. Most of the patients are recruited from the Department of Heart Disease, n = 69 (31%) and Thoracic Medicine, n = 98 (45%). The recruitment of patients faces many challenges, including a high degree of non-participation (about one in four patients), and a high degree of misclassification (patients falsely categorized as ‘not at nutritional risk’).Conclusion:The study is unique due to the integration of patient-derived data on quality of life, food intake, and socio-economic factors with multiple and complementary nutritional biomarkers. A first result from the recruitment period is the need for specification of the specificity and sensitivity of screening tools for malnutrition in hospitals under realistic circumstances. This should ideally be tested in a multicentre study

PP332 NUTRITIONAL RISK SCREENING (NRS 2002) IN HOSPITALIZED PATIENTS: FOCUS ON FOOD INTAKE DECREASE

2010 ◽  
Vol 5 (2) ◽  
pp. 153
Author(s):  
M. Arvanitakis ◽  
A. Lintermans ◽  
M. Raedemaeker ◽  
A. Coudray ◽  
S. Vereecken ◽  
...  
Keyword(s):  
Food Intake ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Risk Screening ◽  
Nrs 2002 ◽  
Nutritional Risk Screening
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