VolumeVol. 56 • Number No. 4 • October - December 2018 Back
Nutritional Status and Hospital Outcomes of In-patients in a Tertiary Hospital
Authors: Lyzanne Maryl Tam-Go, Imelda Lagura-Bilocura, Ceryl Cindy Tan
DOI: 10.65564/pjim.14f9ca0b3a
Date of Publication: December 2018
Abstract
Introduction: Malnutrition is a widespread condition that impacts millions of people across the world annually. The World Health Organization defines malnutrition as the deficiency, excess or imbalance in a person’s intake of energy and/or nutrients. It has been highly prevalent in hospitalized patients and is often overlooked as it continues to be an unrecognized problem. It is also associated with increased risk of complications, higher mortality rate, longer hospital stay, and higher hospitalization costs. The researchers aim to determine in-patients’ nutritional status using the Subjective Global Assessment (SGA) and their outcomes in a tertiary hospital.
Methods: A cross-sectional study was conducted in a tertiary hospital in Cebu city for three months. A total of 453 patients were selected through simple random sampling from those assessed to be at risk for malnutrition. The nutritional status was obtained using the SGA tool and correlated with the demographic, nutritional and clinical profiles.
Results: In the study, the mean age was 54 years with a female predominance (54.1%). A larger percentage belonged to the obese 1 category (34.9%). Fifty-eight percent had moderate risk for malnutrition and 57.2% had an SGA grade of B which corresponded to moderate malnutrition. The most common reason of admission was due to respiratory causes (25%) and the leading comorbidities were hypertension (48.79%), diabetes mellitus (36.42%) and chronic kidney disease (10.38%). The mean number of hospital stay was 6.8 days (98.9%) were discharged improved with a mortality rate of only one percent. The following factors had a positive relationship with the SGA grade: those in the older age group (p=0.000), those with more comorbidities (p=0.000), patients with diabetes (p=0.027) and chronic kidney diseases (0.001), those with higher nutritional risk on screening (p=0.000), those with pulmonologic (p=0.035) and oncologic cases (p=0.012) upon admission. The study results showed that the higher the SGA grade, the longer hospital stay (p=0.000).
Conclusion: In this study, the prevalence of malnutrition was 86% wherein 57.2% of the study population had moderate malnutrition, 28.9% had severe malnutrition and 13.9% had no malnutrition. The degree of malnutrition was associated with longer hospital stay, but not with mortality.
Keywords: malnutrition, subjective global assessment, nutritional status
References
- World Health Organization. What is malnutrition? 2016. Available at http://www.who.int/features/qa/malnutrition/en/
- Tappenden K, Quatrara B, Pakhurst M, Malone MS, Fanjiang G, Ziegler T; Critical role of nutrition in improving quality of care: An interdisciplinary Call to action to address adult hospital malnutrition. Journal of the Academy of Nutrition and Dietetics, 113:9, 2013.
- Demaio A, Branca F. Decade of action on nutrition: our window to act on the double burden of malnutrition. BMJ Glob Health, 3:1:e000492, 2018.
- Rasmussen H, Holst M, Kondrup J; Measuring nutritional risk in hospitals. Dove Press Journal, 2:209-216, 2010.
- Barker L, Gout B, Crowe T; Hospital malnutrition: Prevalence, identification and impact on patients and the healthcare system. Internal Journal of Environmental Research and Public Health; 8:2:514-527, 2011.
- Chern, Camilla, Lee, Shyh-Dye; Malnutrition in Hospitalized Asian Seniors. An Issue that Call for Action. Journal of Clinical Gerontology and Geriatrics, 6:3: 73-77, 2015.
- Subjective global assessement 2012. Available at www.subjectiveglobalassessment.com
- Makhija S, Baker J; The subjective global assessment: A review of its use in clinical practice.Nutrition in clinical practice, 23:405, 2008.
- Allard J, Keller H, Jeejeebhoy K, Laporte M, Duerksen D, Gramlich L, Payette H, Bernier P, Vesnaver E, Davidson B, Teterina A, Lou W; Malnutrition at Hospital Admission—Contributors and Effect on Length of Stay: A Prospective Cohort Study From the Canadian Malnutrition Task Force. Journal of Parenteral and Enteral Nurtrition, 40:4; 487-497, 2016.
- Imoberdorf R, Ballmer PE; Epidemiology of Malnutrition. Ther Umsch. 71:3;123-126, 2014.
- Wells J, Dumbrell A; Nutrition and aging: assessment and treatment of compromised nutritional status in frail elderly patients. Clinical Interventions in Aging, 1:1:67-69, 2006.
- Moriana M, Civera M, Artero A, Real J, Caro J, Ascaso J, Martinez-Valls J; Validity of subjective global assessment as a screening method for hospital malnutrition. Prevalence of malnutrition in a tertiary hospital. Endocrinology Nutrition , 61:4: 184-189, 2014.
- Middleton M.H., Nazarenko G, Nivison-Smith I, Smerdely P; Prevalence of Malnutrition and 12-Month Incidence of Mortality in Two Sydney Teaching Hospitals. Internal Medicine Journal, 31:455-461, 2001.
- Cabangon M, Narvacan-Montano C, del Rosario-Capellan M, Campos-Cagingin M; Prevalence of Malnutrition Among Patients with Diabetes Mellitus Type 2 Admitted in a Tertiary Hospital. Philippine Journal of Internal Medicine, 54:2, 2016.
- Dominguez R; Burden of Malnutrition in a Tertiary Care Hospital in Baguio City. SAGE Open, 3:3:1-7, 2013.
- Florentino R; The double burden of malnutrition in Asia: a phenomenon not to be discussed. Journal of the ASEAN federation of Endocrine Societies, 26:2, 2011.
- Food and Research Institute. Eighth National Nutritional Survey 2013-2014. Available at fnri.dost.gov.ph.
- Salahudeen A, Fleischmann E, Bower J , Hall J; Underweight rather than overweight is associated with higher prevalence of hypertension: BP vs. BMI in haemodialysis population, 19:2, 2004.
- Tongo M, Sy R; The relation of mini nutritional screening score, subjective global assessment of nutrition and pneumonia severity index in elderly patients diagnosed with community acquired pneumonia admitted at Cardinal Santos Medical Center: An observational, analytical and cross sectional study. Journal of Nutrition Food and Science, 6:8, 2016.
- Santarpia L, Contaldo F, Pasanisi F; Nutritional screening and early treatment of malnutrition in cancer patients. Journal of Cachexia Sarcopenia Muscle, 2:27-35, 2011.