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Analysis of the Prevalence and Risk Factors of Malnutrition among Hospitalized Patients in Busan

  • Lee, Ha-Kyung (Centum Erooda Hospital) ;
  • Choi, Hee-Sun (Department of Food Science and Nutrition, Dong-A University) ;
  • Son, Eun-Joo (Department of Nutrition Care, Dongnam Institute of Radiological & Medical Sciences) ;
  • Lyu, Eun-Soon (Department of Food Science and Nutrition, Pukyong National University)
  • Received : 2013.04.03
  • Accepted : 2013.05.27
  • Published : 2013.06.30

Abstract

This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.

Keywords

References

  1. 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
  2. Butterworth CE. 1974. The skeleton in the hospital closet. Nutr Today 9: 4-8.
  3. McWhirter JP, Pennington CR. 1994. Incidence and recognition of malnutrition in hospital. BMJ 308: 945-948. https://doi.org/10.1136/bmj.308.6934.945
  4. Edington J, Boorman J, Durrant ER, Perkins A, Giffin CV, James R, Thomson JM, Oldroyd JC, Smith JC, Torrance AD, Blackshaw V, Green S, Hill CJ, Berry C, Mckenzie C, Vicca N, Ward JE, Coles SJ. 2000. Prevalence of malnutrition on admission to four hospitals in England. Clin Nutr 19: 191-195. https://doi.org/10.1054/clnu.1999.0121
  5. Waitzberg DL, Caiaffa WT, Correia MI. 2001. Hospital malnutrition: the Brazilian national survey (IBRANUTRI): a study of 4000 patients. Nutrition 17: 573-580. https://doi.org/10.1016/S0899-9007(01)00573-1
  6. Correia MI, Waitzberg DL. 2003. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 22: 235-239. https://doi.org/10.1016/S0261-5614(02)00215-7
  7. Roediger WE. 1994. Famine, fiber, fatty acids, and failed colonic absorption: Does fiber fermentation ameliorate diarrhea? JPEN 18: 4-8. https://doi.org/10.1177/014860719401800104
  8. Green CJ. 1999. Existence, causes and consequences of disease-related malnutrition in the hospital and the community, and clinical and financial benefits of nutritional intervention. Clin Nutr 18: 3-28. https://doi.org/10.1016/S0261-5614(99)80042-9
  9. Schneider SM, Veyres P, Pivot X, Soummer AM, Jambou P, Filippi J, van Obberghen E, Hébuterne X. 2004. Malnutrition is an independent factor associated with nosocomial infections. Br J Nutr 92: 105-111. https://doi.org/10.1079/BJN20041152
  10. Kyle UG, Kossovsky MP, Karsegard VL, Pichard C. 2006. Comparison of tools for nutritional assessment and screening at hospital admission: A population study. Clin Nutr 25: 409-417. https://doi.org/10.1016/j.clnu.2005.11.001
  11. Rasmussen HH, Kondrup J, Staun M, Ladefoged K, Kristensen H, Wengler A. 2004. Prevalence of patients at nutritional risk in Danish hospitals. Clin Nutr 23: 1009-1015. https://doi.org/10.1016/j.clnu.2004.01.001
  12. Dougherty D, Bankhead R, Kushner R, Mirtallo J, Winkler M. 1995. Nutrition care given new importance in Jcaho Standards. Nutr Clin Pract 10: 26-31. https://doi.org/10.1177/011542659501000126
  13. Brugler L, Stankovic AK, Schlefer M, Bernstein L. 2005. A simplified nutrition screen for hospitalized patients using readily available laboratory and patient information. Nutrition 21: 650-658. https://doi.org/10.1016/j.nut.2004.10.012
  14. Bozzetti F. 1987. Nutritional assessment from the perspective of a clinician. J Parent Enteral Nutr 11: 115S-121S. https://doi.org/10.1177/014860718701100518
  15. Baker JP, Detsky AS, Wesson DE, Wolman SL, Stewart S, Whitewell J, Langer B, Jeejeebhoy KN. 1982. Nutritional assessment: a comparison of clinical judgment and objective measurements. New Engl J Med 306: 969-972. https://doi.org/10.1056/NEJM198204223061606
  16. Veterans Affairs Total Parenteral Nutrition Cooperative Study Group. 1991. Perioperative total parenteral nutrition in surgical patients. New Engl J Med 324: 525-532.
  17. Elia M, British Association for Parenteral and Enteral Nutrition, Malnutrition Advisory Group. 2000. Guidelines for detection and management of malnutrition. Maidenhead, Redditch, UK.
  18. Kondrup J, Allison SP, Elia M, Vellas B, Plauth M. 2003. ESPEN guidelines for nutrition screening 2002. Clin Nutr 22: 415-421. https://doi.org/10.1016/S0261-5614(03)00098-0
  19. Rha MY. 2006. Effects of clinical outcome of hospitalized patients by means of nutritional status. MS Thesis. Seoul National University, Seoul, South Korea.
  20. Kim SA, Kim SY, Sohn C. 2006. Development of nutrition screening index for hospitalized patients. Korean J Community Nutr 11: 779-784.
  21. Bruun LI, Bosaeus I, Bergstad I, Nygaard K. 1999. Prevalence of malnutrition in surgical patients: evaluation of nutritional support and documentation. Clin Nutr 18: 141-147. https://doi.org/10.1016/S0261-5614(99)80003-X
  22. Robinson G, Goldstein M, Levine G. 1987. Impact of nutritional status on DRG length of stay. JPEN 11: 49-51. https://doi.org/10.1177/014860718701100149
  23. Kim YH, Seo AR, Kim MK, Lee YM. 1999. Relationship of nutritional status at the time of admission to length of hospital stay (LOS) and mortality: A prospective study based on computerized nutrition screening. J Korean Diet Assoc 5: 48-53.
  24. Kyle UG, Pirlich M, Schuetz T, Lochs H, Pichard C. 2004. Is nutritional depletion by Nutritional Risk Index associated with increased length of hospital stay? A population-based study. J Parenter Enteral Nutr 28: 99-104. https://doi.org/10.1177/014860710402800299
  25. Chung SH, Sohn JM. 2005. Nutritional status of hospitalized geriatric patients using by the mini nutritional assessment. Korean J Community Nutrition 10: 645-653.
  26. Pirlich M, Schutz T, Norman K, Gastell S, Lubke HJ, Bischoff SC, Bolder U, Frieling T, Guldenzoph H, Hahn K, Jauch KW, Schindler K, Stein J, Volkert D, Weimann A, Werner H, Wolf C, Zurcher G, Bauer P, Lochs H. 2006. The German Hospital Malnutrition Study. Clin Nutr 25: 563-572. https://doi.org/10.1016/j.clnu.2006.03.005
  27. Amaral TF, Matos LC, Tavares MM, Subtil A, Martins R, Nazare M, Pereira NS. 2007. The economic impact of disease-related malnutrition at hospital admission. Clin Nutr 26: 778-784. https://doi.org/10.1016/j.clnu.2007.08.002
  28. Korfali G, Gundogdu H, Aydıntug S, Bahar M, Besler T, Moral AR, Oguz M, Sakarya M, Uyar M, Kılıcturgay S. 2009. Nutritional risk of hospitalized patients in Turkey. Clin Nutr 28: 533-537. https://doi.org/10.1016/j.clnu.2009.04.015
  29. Liang X, Jiang ZM, Nolan MT, Wu X, Zhang H, Zheng Y, Liu H, Kondrup J. 2009. Nutritional risk, malnutrition (undernutrition), overweight, obesity and nutrition support among hospitalized patients in Beijing teaching hospitals. Asia Pac J Clin Nutr 18: 54-62.
  30. Guo W, Ou G, Li X, Huang J, Liu J, Wei H. 2010. Screening of the nutritional risk of patients with gastric carcinoma before operation by NRS 2002 and its relationship with postoperative results. J Gastroenterol Hepatol 25: 800-803. https://doi.org/10.1111/j.1440-1746.2009.06198.x
  31. Raja R, Lim AV, Lim YP, Lim G, Chan SP, Vu CKF. 2004. Malnutrition screening in hospitalized patients and its implication on reimbursement. Intern Med J 34: 176-181. https://doi.org/10.1111/j.1444-0903.2004.00518.x
  32. Vanderwee K, Clays E, Bocquaert I, Gobert M, Folens B, Defloor T. 2010. Malnutrition and associated factors in elderly hospital patients: a Belgian cross-sectional, multicentre study. Clin Nutr 22: 147-152.
  33. Gout BS, Barker LA, Crowe TC. 2009. Malnutrition identification, diagnosis and dietetic referrals: Are we doing a good enough job. Nutr Diet 66: 206-211. https://doi.org/10.1111/j.1747-0080.2009.01372.x
  34. Braunschweig C, Gomez S, Sheean PM. 2000. Impact of declines in nutritional status on outcomes in adult patients hospitalized for more than 7 days. J Am Diet Assoc 100: 1316-1322. https://doi.org/10.1016/S0002-8223(00)00373-4
  35. Middleton MH, Nazarenko G, Nivison-Smith I, Smerdely P. 2001. Prevalence of malnutrition and 12-month incidence of mortality in two Sydney teaching hospitals. Int Med J 31: 455-461. https://doi.org/10.1046/j.1445-5994.2001.00109.x
  36. Rasmussen HK, Kondrup J, Staun M, Ladefoged K, Krostensen H, Wengler A. 2004. Prevalence of patients at nutritional risk in Danish hospitals. Clin Nutr 23: 1009-1015. https://doi.org/10.1016/j.clnu.2004.01.001
  37. Smith PE, Smith AE. 1997. High-quality nutritional interventions reduce costs. Health Finan Manage 51: 66-69.
  38. Song MS. 2008. A study on nutritional status of rehabilitation in-patients with stroke. MS Thesis. Yonsei University, Seoul, South Korea.
  39. Isenring E, Capra S, Bauer J. 2004. Nutrition intervention is beneficial in oncology outpatients receiving radiotherapy to the gastrointestinal or head and neck area. Br J Cancer 91: 447-452. https://doi.org/10.1038/sj.bjc.6601962
  40. Ravasco P, Monteiro-Grillo I, Vidal PM, Carmilo ME. 2005. Dietary counseling improves patient outcomes: A prospective, randomized, controlled trial in colorectal cancer patients undergoing radiotherapy. J Clin Oncol 23: 1431-1438. https://doi.org/10.1200/JCO.2005.02.054
  41. Baldwin C, Weekes CE. 2008. Dietary advice for illnessrelated malnutrition in adults. Cochrane Database Syst Rev 1. CD002008.

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