Dietary considerations for the sick and hospitalized patients

From a clinical perspective, knowledge of the nutritional status of a hospitalized patient is an indispensable strategy for establishing an adequate approach to the maintenance and/or recovery of nutritional status during the hospital stay. Nutritional status has an important impact on the course of underlying diseases. Malnutrition increases the rate of morbidity, length of hospital stay and certain other complications. Therefore malnutrition becomes very common among hospitalized patients which in turn lead to morbidity and increased hospital stay. Nutritional requirement of the patient vary in different disease condition and their mode of feeding depends upon the condition of the patient and the functioning organ Health Renaissance 2015;13 (1):

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Acute Diverticulitis Is at Significant Risk of Malnutrition: an Analysis of Hospitalized Patients in a Medicine Department

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-561 ◽

2020 ◽

Vol 28 ◽

pp. 53-56

Author(s):

GianMarco Giorgetti ◽

Federica Fabiocchi ◽

Giovanni Brandimarte ◽

Antonio Tursi

Keyword(s):

Nutritional Status ◽

Hospital Stay ◽

Large Scale ◽

Acute Diverticulitis ◽

Significant Risk ◽

Length Of Hospital Stay ◽

Tertiary Hospital ◽

Hospitalized Patients ◽

Nutritional Risk ◽

Medicine Department

Background and Aim: The Nutritional Risk Security (NRS2002) System is recommended for hospitalized patients in order to assess their nutritional status. However, studies assessing large-scale systematic screening policies are lacking. The aim of this study was to assess the feasibility of implementing a screening strategy concerning all admissions for diverticular disease (DD) of the colon in the Department of Medicine of a Tertiary Hospital. Methods: All patients suffering from acute diverticulitis (AD) and admitted to the Medicine Department from January 1st to 31 December 2017, were pre-screened by NRS2002 System by the nursing staff of the Nutritional team at the day of the admission. If the pre-screening was positive, the patients were referred to a supplementary assessment performed by a dietician. Results: The global number of admissions in the observational period was 4,667 and 133 patients suffered from AD. A positive pre-screening test was recorded in 97 (72.9%) patients: a NRS2002 score > 3, describing a severe impaired nutritional status was found in 61 patients (62.9%). All 97 patients with a NRS2002 positive screening received initial nutritional support by oral supplements (17 patients, 17.52%) or enteral nutrition (22 patients, 22.68%) or total parenteral nutrition (58 patients, 59.8%). The mean length of hospital stay for all 133 patients was 6,9 days. However, the length of hospital stay was significantly longer for patients with a positive NRS2002, with a mean of 18 days (p= 0.01) Conclusions: A large number of hospitalized patients due to AD are at nutritional risk and have a significantly longer hospital stay.

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1464. Adjuvant Systemic Steroid Therapy and Length of Hospital Stay in Pneumonia Patients: A Retrospective Cohort Study in a Community Hospital

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1645 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S733-S734

Author(s):

Rattanaporn Mahatanan

Keyword(s):

Hospital Stay ◽

Steroid Therapy ◽

Subgroup Analysis ◽

Community Hospital ◽

Length Of Hospital Stay ◽

Hospitalized Patients ◽

Systemic Steroid ◽

Inpatient Mortality ◽

Copd Patients ◽

Class Iv

Abstract Background Pneumonia is a leading cause of morbidity and mortality worldwide resulting in a substantial healthcare expenditure. Antimicrobial agents are the main treatment. Recent studies showed the benefits of steroid therapy as an adjuvant therapy for patients with pneumonia; however, the overall evidence is still controversial. Methods Electronic medical records of hospitalized patients (age >18) at a community hospital in a rural Maine with the discharge diagnosis of pneumonia in 2015 and 2016 were reviewed. Demographics, comorbidities, physical examination, initial laboratory, and Pneumonia Severity Index (PSI) were collected for each patient. The exposure was a systemic steroid administered by either oral or intravenous. The outcomes included length of hospital stay (LOS), inpatient mortality, and transfer to tertiary care center. Competing-risks regression was utilized to examine the association between steroid and LOS. Multivariable logistic regression analysis adjusted for propensity score was used for other outcomes. Results A total of 414 patients were included. 277(63%) patients received systemic steroids. Overall, steroid use was significantly associated with shorter LOS (HR 1.26, 95%CI 1.03-1.54, p=0.02) and decrease inpatient mortality (OR 0.11, 95%CI 0.03-0.45, p< 0.01). In subgroup analysis, steroid associated with shorter LOS only in patients with PSI class IV (HR 1.38, 95%CI 1.02-1.89, p=0.04) and PSI class V (HR 2.04, 95%CI 1.11-3.74, p=0.02). There was an association of steroid and shorter LOS in subgroup of COPD patients (HR 1.42, 95%CI 1.02-1.97, p=0.03). Table 1: The baseline characteristics of hospitalized patients with a diagnosis of pneumonia who received steroid vs non-steroid Figure 1: Subgroup analysis the effect of steroid and lenght of hospital stay (LOS) Conclusion Our study concluded that adjuvant steroid therapy associated with a decrease in length of hospital stay and improved inpatient mortality in hospitalized pneumonia patients. Steroid was most beneficial to those with severe pneumonia (PSI class IV-V) and COPD patients. Disclosures All Authors: No reported disclosures

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Recognising anaemia and malnutrition in vascular patients with critical limb ischaemia

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12664192075738 ◽

2010 ◽

Vol 92 (6) ◽

pp. 495-498 ◽

Cited By ~ 6

Author(s):

M Shah ◽

A Martin ◽

B Myers ◽

S MacSweeney ◽

T Richards

Keyword(s):

Nutritional Status ◽

Hospital Stay ◽

Nutritional Assessment ◽

Length Of Hospital Stay ◽

Critical Limb Ischaemia ◽

Limb Ischaemia ◽

Patient Demographics ◽

Laboratory Markers ◽

Bed Days ◽

Poor Nutrition

INTRODUCTION Anaemia is a common problem in surgical patients. Patients with critical limb ischaemia (CLI) suffer chronic inflammation, repeated infection, require intervention, and can have a protracted hospital stay. The aims of this study were to assess anaemia and nutritional status in patients presenting with CLI. PATIENTS AND METHODS Two observational studies were undertaken, initially a retrospective series of 27 patients with CLI. Patient demographics, clinical details, transfusion status and in-patient laboratory haemoglobin values (Hb) were recorded. In a prospective series of 32 patients, laboratory markers to identify the cause for anaemia were assessed. Further nutritional status was assessed by records of height, weight, body mass index and a validated scoring system. RESULTS In the retrospective series, 15 patients (56%) were anaemic. Ten (37%) were transfused a median of 2 units (range, 2–13), a total of 35 units. Patients who were transfused had lower Hb on admission (P = 0.0019), most were anaemic on admission (90%). At discharge, most patients were anaemic (n = 23; 83%). In the prospective series of 32 patients, 20 (63%) were anaemic. Nutritional assessment was performed on 18, only seven patients were scored undernourished. This was increased to 23 by an independent assessor. Anaemia was associated with malnutrition (n = 17; P = 0.049) and an increased hospital stay (mean 25 days [SD 16] vs mean 12 days [SD 8], P = 0.0125; total 513 vs 144 bed days). CONCLUSIONS Anaemia and poor nutrition are common and not recognised in vascular patients presenting with critical limb ischaemia. Anaemia is associated with and increased length of hospital stay.

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