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Hospital food consumption can affect patients’ outcome leading to prolonged hospital stay or even increased mortality. In the present study, the nutritionDay database was analyzed (period 2006–2013) to explore the reasons for re...
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Hospital food consumption can affect patients’ outcome leading to prolonged hospital stay or even increased mortality. In the present study, the nutritionDay database was analyzed (period 2006–2013) to explore the reasons for reduced food intake andassociated factors during hospitalization as reported by the patients per se.MethodsData from 113,930 adult patients (male 49.9%; mean age 64.0 ± 18.1 y, mean BMI 25.7 ± 6.0 kg/m2) (from 4519 units, 1358 hospitals, 54 countries) were included. Dietary intake and reasons for reduced food intake were reported and analyzed.ResultsOnly 41.6% of patients reported to have consumed all their served meal, whereas 9.3% ate nothing although allowed to eat. Variables like presence of caner, having nausea/vomiting, feeling tired, not feeling hungry and not liking food's taste increased the likelihood of consuming “ of the meal” but not “nothing”. Variables like having gastrointestinal disorder, being bedrest, receiving nutritional support and not liking food's smell increased the likelihood of both decreased ( compared to ) and null(nothing compared to ) food consumption (all p < 0.001).ConclusionsFood consumption during hospitalization is associated with variables related to both patients’ condition (e.g. clinical, physical) and factors related to the quality of hospital food.
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Malnutrition is considered a risk factor for many complications and mortality among hospitalized patients. Until 2016 there was a wide variety of clinical definitions for malnutrition, until the GLIM criteria proposed a consensual...
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Malnutrition is considered a risk factor for many complications and mortality among hospitalized patients. Until 2016 there was a wide variety of clinical definitions for malnutrition, until the GLIM criteria proposed a consensual definition. The maingoal of this study is to assess the performance of the GLIM criteria at acute care admission to detect those patients with adverse clinical outcomes such as mortality and the need to be transferred to critical care areas (CCA).MethodsThis was a prospective observational study including every adult patient admitted to the regular ward of the Hospital San ángel Inn Universidad. Every nutrition and demographic variable evaluated by the nutrition team at hospital admission was captured.The malnutrition definition according to the GLIM and separate criteria were tested for their performance to detect patients at high risk for adverse outcomes (mortality and the need to be transferred to CCA), using odd ratios (OR), their confidence interval of 95% (CI95%) and binary logistic regression accordingly.ResultsA total of 1015 patients were included in the final analysis, with a prevalence of 18.9% of malnutrition (according to the GLIM definition) at hospital admission. Malnutrition was associated with mortality (OR of 59.69,CI95% 7.76–459.28) and unplanned transfer to CCA (OR of 9.453, CI95%4.35–20.56). However, despite being sensitive, the GLIM definition of malnutrition, displayed low positive predictive value, and was therefore associated with many false positives. There was a trend for higher risks foradverse outcomes with higher severity of malnutrition. Muscle wasting, chronic and acute inflammation were independent predictors for mortality and for unplanned transfer to CCA.ConclusionsMalnutrition according to the GLIM criteria is strongly associated with mortality and transfer to CCA. Muscle wasting and inflammation (acute and chronic) were independently associated with these outcomes.
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Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common interv...
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Malnutrition is common in acute care hospitals. During hospitalization, poor appetite, medical interventions, and food access issues can impair food intake leading to iatrogenic malnutrition. Nutritional support is a common intervention with demonstrated effectiveness. "Food first" approaches have also been developed and evaluated. This scoping review identified and summarized 35 studies (41 citations) that described and/or evaluated dietary, foodservice, or mealtime interventions with a food first focus. There were few randomized control trials. Individualized dietary treatment leads to improved food intake and other positive outcomes. Foodservices that promote point-of-care food selection are promising, but further research with food intake and nutritional outcomes is needed. Protected mealtimes have had insufficient implementation, leading to mixed results, while mealtime assistance, particularly provided by volunteers or dietary staff, appears to promote food intake. A few innovative strategies were identified but further research to develop and evaluate food first approaches is needed.
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Background: Malnutrition is common in the developing world and associated with disease and mortality. Because malnutrition frequently occurs among children in the community as well as those with acute illness, and because anthropo...
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Background: Malnutrition is common in the developing world and associated with disease and mortality. Because malnutrition frequently occurs among children in the community as well as those with acute illness, and because anthropometric indicators of nutritional status are continuous variables that preclude a single definition of malnutrition, malnutrition-attributable fractions of admissions and deaths cannot be calculated by simply enumerating individual children.
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Abstract Background Hospital malnutrition is an important health problem for developed and developing countries, and screening tools are recommended in practice because they can be obtained quickly and easily to identify the risk ...
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Abstract Background Hospital malnutrition is an important health problem for developed and developing countries, and screening tools are recommended in practice because they can be obtained quickly and easily to identify the risk of malnutrition. This study aimed to validate the use of the Graz Malnutrition Screening (GMS) in combination with different methods of nutrition assessment in the identification of malnutrition risk in hospitalized adult and older patients. Methods The study was performed with a total of 348 adult (64.4%) and older (35.6%) patients treated in the internal and surgical clinical units of Ankara Gazi Hospital between May and July 2019. A questionnaire including general information, anthropometric measurements, and biochemical parameters was applied. The Nutritional Risk Screening‐2002 (NRS‐2002), Short Nutritional Assessment Questionnaire (SNAQ), and GMS were applied, and results were evaluated by comparison. Results The mean age of the patients was 57.0 years, and the mean hospital length of stay (LOS) was 7.9 days. According to GMS, malnutrition risk was found in 47.7% of the patients. When NRS‐2002 was taken as a reference, the sensitivity and specificity of GMS were calculated as 95.16% and 78.57%, respectively, and Cohen's kappa coefficient was 0.686. When SNAQ was taken as a reference, the sensitivity and specificity of GMS were calculated as 91.59% and 75.11%, respectively, and Cohen's kappa coefficient was 0.609. Conclusion GMS can be used as a valid screening tool to identify malnutrition risk in both adult and older patients in the different hospital departments in Turkey.
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Background: Little is known about the nutritional care provided to patients who develop hospital acquired malnutrition (HAM). The present study aimed to describe the quality of nutritional care provided to patients who developed H...
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Background: Little is known about the nutritional care provided to patients who develop hospital acquired malnutrition (HAM). The present study aimed to describe the quality of nutritional care provided to patients who developed HAM and determine whether this differed by length of stay (LOS).Methods: A retrospective medical records audit was conducted on adults with LOS > 14 days across five Australian public hospitals from July 2015 to January 2019 who were clinically assessed to have HAM. Descriptors and nutrition-related care data were sourced. Descriptive statistics were conducted. Chi-squared and t-tests were used to compare patient data by LOS < or > 50 days.Results: Eligible patients (n = 208) were 64% male, with median (range) LOS of 51 (15354) days, body mass index = 26.8 ± 6.2 kg m-2 and mean ± SD age of 65 ± 17 years. Malnutrition screening was first completed a median (range) of 0 (0-31) days after admission, with weekly screening conducted on 29% of patients. Mean (range) time to initial dietitian assessment was 9 (0-87) days and 27 (2-173) days until malnutrition diagnosis. Thirty-seven percent of patients were weighed within 24 h of a dietitian requesting it, and 51% had fluid retention that may have masked further weight loss. Most (91%) patients consumed < 80% of nutrition requirements for > 2 weeks. However, 54% did not receive additional nutrition support (e.g., enteral nutrition), which was not considered by the dietitian in 28% (n = 31/112) of these patients. Only 40% consumed adequate intake prior to discharge. Those with LOS > 50 days (50%, n = 104/208) took 24 days longer to be diagnosed with malnutrition and lost 2.4 kg more body weight during admission (p < 0.010).Conclusions: Opportunities exist to optimise nutritional care to facilitate the prevention and management of hospital acquired malnutrition in long-stay patients.
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Malnutrition remains common but unrecognized and untreated problem worldwide particularly in Iranian hospitals. Malnutrition has a high clinical and economic impact reflected by an increased morbidity and mortality and prolonged h...
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Malnutrition remains common but unrecognized and untreated problem worldwide particularly in Iranian hospitals. Malnutrition has a high clinical and economic impact reflected by an increased morbidity and mortality and prolonged hospital stay. The main aim of this study was to assess the nutritional state of patients on admission to four University-affiliated hospitals including two general, one oncology and one psychiatric) in Mashhad using of Malnutrition Universal Screening Tool (MUST). 404 adults aged more than 18 who were admitted to the Mashhad teaching hospitals were screened for malnutrition using MUST. The mean age was 44 ± 18 years (range 18–90 years) (188 females, 216 males). The nutritional status assessment was performed within 48 h of admission and the prevalence of malnutrition was reported 48.5%. (high risk 38.6%, medium risk 9.9%). In total, 45.2% (n = 70) of female patients had a MUST score of 2 (high risk) when compared with 51.5% (n = 35) of males. Mental disorder patients (82%) and medical ward patients (60.6%) had the highest prevalence of malnutrition. Results showed that malnutrition is a common problem affecting more than 48% of patients in this hospital-wide study. Results warrant paying more attention to malnourished patients.
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Malnutrition remains common but unrecognized and untreated problem worldwide particularly in Iranian hospitals. Malnutrition has a high clinical and economic impact, reflected by an increased morbidity and mortality and prolonged ...
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Malnutrition remains common but unrecognized and untreated problem worldwide particularly in Iranian hospitals. Malnutrition has a high clinical and economic impact, reflected by an increased morbidity and mortality and prolonged hospital stay. The main aim of this study was to assess the nutritional state of patients on admission to four University-affiliated hospitals including two general, one oncology and one psychiatric) in Mashhad using of Malnutrition Universal Screening Tool (MUST). 404 adults aged more than 18 who were admitted to the Mashhad teaching hospitals were screened for malnutrition using MUST. The mean age was 44 +- 18 years (range 18-90 years) (188 females, 216 males). The nutritional status assessment was performed within 48 h of admission and the prevalence of malnutrition was reported 48.5%. (high risk 38.6%, medium risk 9.9%). In total, 45.2% (n = 70) of female patients had a MUST score of 2 (high risk) when compared with 51.5% (n = 35) of males. Mental disorder patients (82%) and medical ward patients (60.6%) had the highest prevalence of malnutrition. Results showed that malnutrition is a common problem affecting more than 48% of patients in this hospital-wide study. Results warrant paying more attention to malnourished patients.
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The Controlling Nutritional Status (CONUT) score is a simple screening tool able to detect altered nutritional status as well as to predict clinical adverse outcomes in specific populations. No data are available in frail patients...
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The Controlling Nutritional Status (CONUT) score is a simple screening tool able to detect altered nutritional status as well as to predict clinical adverse outcomes in specific populations. No data are available in frail patients. This study aims to investigate the predictive role of the CONUT score on mortality and length of stay (LOS) in frail patients admitted to an Internal Medicine Department. We consecutively enrolled 246 patients aged 65 years or older, divided into two groups based on frailty status. The two groups were further divided according to low (<5) or high (≥5) CONUT score. Length of stay (LOS) was higher in frail patients than not-frail patients, as well as in the frail group with high CONUT scores compared to the frail group with low CONUT scores. Multiple linear regression showed an increase of 2.1 days for each additional point to the CONUT score. In-hospital mortality was higher in frail compared to not-frail patients, but it did not differ between frail patients with high CONUT scores and frail patients with low CONUT scores. An analysis of the survival curve for 30-day mortality showed a higher mortality rate for frail/high-CONUT-score patients as compared to the not-frail/low-CONUT-score group. The CONUT score shows high prognostic value for higher LOS—but not mortality—in the clinical setting of internal medicine departments for old frail patients.
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