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

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.

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Prognostic Indices of Poor Nutritional Status and Their Impact on Prolonged Hospital Stay in a Greek University Hospital

BioMed Research International ◽

10.1155/2014/924270 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 19

Author(s):

Georgia Tsaousi ◽

Stavros Panidis ◽

George Stavrou ◽

John Tsouskas ◽

Dimitrios Panagiotou ◽

...

Keyword(s):

Weight Loss ◽

Food Intake ◽

Nutritional Status ◽

University Hospital ◽

Hospital Length Of Stay ◽

Nutritional Risk ◽

Nutrition Status ◽

Artificial Nutrition ◽

Arm Circumference ◽

Poor Nutritional Status

Background. To ascertain the potential contributors to nutritional risk manifestation and to disclose the factors exerting a negative impact on hospital length of stay (LOS), by means of poor nutritional status, in a nonselected hospitalized population.Materials and Methods. NutritionDay project questionnaires were applied to 295 adult patients. Study parameters included anthropometric data, demographics, medical history, dietary-related factors, and self-perception of health status. Body Mass Index (BMI) and Malnutrition Universal Screening Tool (MUST) were calculated for each participant. MUST score was applied for malnutrition assessment, while hospital LOS constituted the outcome of interest.Results. Of the total cohort, 42.3% were at nutritional risk and 21.4% malnourished. Age, gender, BMI, MUST score, autonomy, health quality, appetite, quantity of food intake, weight loss, arm or calf perimeter (P<0.001, for all), and dietary type (P<0.01) affected nutritional status. Poor nutrition status (P=0.000), deteriorated appetite (P=0.000) or food intake (P=0.025), limited autonomy (P=0.013), artificial nutrition (P=0.012), weight loss (P=0.010), and arm circumference <21 cm (P=0.007) were the most powerful predictors of hospital LOS >7 days.Conclusion. Nutritional status and nutrition-related parameters such as weight loss, quantity of food intake, appetite, arm circumference, dietary type, and extent of dependence confer considerable prognostic value regarding hospital LOS in acute care setting.

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Malnutrition and cancer, diagnosis and treatment

memo - Magazine of European Medical Oncology ◽

10.1007/s12254-020-00672-3 ◽

2021 ◽

Author(s):

Angelika Beirer

Keyword(s):

Weight Loss ◽

Cancer Patients ◽

Cancer Cachexia ◽

Screening Tool ◽

Psychological Treatment ◽

Early Stage ◽

Nutritional Therapy ◽

German Society ◽

Fat Free Mass ◽

Nutritional Risk

Summary Background The prevalence of malnutrition in cancer patients ranges from about 20% to more than 70%. However, 10–20% of cancer patients’ deaths are related to malnutrition, not the malignancy itself. To reverse the pattern of weight loss, improve the patients’ quality of life, reduce the treatment toxicity, the psychological stress and the risk of mortality, the diagnosis of malnutrition should be made as early as possible to facilitate the best possible treatment. Methods A systematic literature search was conducted following guidelines of ESPEN (European Society for Clinical Nutrition), DGEM (German Society for Nutritional Medicine) and ASPEN (American Society for Parenteral and Enteral Nutrition). Results and conclusion To assess the risk of malnutrition, all cancer patients should be screened regularly with a valid screening tool (e.g., MUST [Malnutrition Universal Screening Tool], NRS [Nutritional Risk Screening] or PG-SGA [Scored Patient-Generated Subjective Global Assessment]). If risk of malnutrition is present, adequate nutritional therapy is recommended to stop involuntary weight loss. Patients should engage in exercise to maintain and improve muscle mass, strength and function. They should be offered regular dietetic counselling, and their muscle depletion should be monitored by determining fat-free mass. As cachectic patients in particular are at risk, the presence of cachexia should also be recognized at an early stage. Three consensus-based definitions are widely accepted: Fearon et al. and the EPCRC (European Palliative Care Research Collaborative) propose definitions specifically for cancer cachexia, while Evans et al. put forward a definition for cachexia associated with all types of underlying chronic diseases. However, if there is a cancer cachexia diagnosis, additional pharmacological and psychological treatment should be considered.

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

International Journal of Emerging Trends in Health Sciences ◽

10.18844/ijeths.v3i2.4487 ◽

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 (2.6Â±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

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Patient-Generated Subjective Global Assessment (PG-SGA) predict Length of hospital stay in lung adenocarcinoma patients

British Journal Of Nutrition ◽

10.1017/s0007114521003500 ◽

2021 ◽

pp. 1-20

Author(s):

Jilu Lang ◽

Yanan Shao ◽

Jiehao Liao ◽

Jia Chen ◽

Xuewen Zhou ◽

...

Keyword(s):

Weight Loss ◽

Nutritional Status ◽

Lung Adenocarcinoma ◽

Hospital Stay ◽

Length Of Hospital Stay ◽

Northern China ◽

Nutritional Risk ◽

Chinese Patients ◽

Nrs 2002 ◽

Northern Chinese

The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma. The PG-SGA, Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 lung adenocarcinoma patients without EGFR mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing lung adenocarcinoma. According to the PG-SGA, 63 (16.3%), 174 (44.7%) and 78 (20.1%) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36.2%) patients based on the NRS 2002. The average LOS for tumor patients in Northern China was 12.5 days. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P<0.001), NRS 2002 (P<0.001), and latest weight loss (P<0.001) predicted the longer LOS. Length of stay was related to nutritional status and hospitalization expenses (P<0.001). Lung adenocarcinoma patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P<0.001). In Northern Chinese patients with lung adenocarcinoma, a risk for undernutrition evaluated by the PG-SGA, the NRS2002 and recent weight loss, but not BMI, could predict a longer LOS.

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Clinical and Nutritional characterization of patients with massive intestinal resection in Ribeirão Preto, SP, Brazil

International Journal of Nutrology ◽

10.1055/s-0040-1705665 ◽

2013 ◽

Vol 06 (01) ◽

pp. 010-014

Author(s):

Vanessa Balbino ◽

Mariana Assad ◽

Juliana Carvalho Machado ◽

Júlio Sérgio Marchini ◽

Maria do Rosário Del Lama de Unamuno ◽

...

Keyword(s):

Weight Loss ◽

Eating Habits ◽

Intestinal Resection ◽

Nutritional Therapy ◽

Clinical Situation ◽

Nutritional Risk ◽

First Year ◽

Significant Weight Loss ◽

Before And After

ABSTRACT Background: Short bowel syndrome (SBS) is a clinical situation due to extensive intestinal resection or dysfunction of the absorptive system of the small intestine. When these patints are not submitted to nutritional therapy their maximum survival is six months. In Brazil there are few reference centers for the treatment and follow-up of these patients and information about their characterization is scarce. Objective: To describe enterectomized patients attended during the period from 1996 to 2007. Methods: All medical records of the patients attended at the Nutrology service of HCFMRP-USP were analyzed retrospectively. Data were collected and analyzed descriptively using the contingency test and the Wilcoxon- Mann-Whitney test for independent samples. Results: Thirty-eight patients with a mean age of 52 years at the time of enterectomy were analyzed, 47% of them males and 53% females. The main etiology of SBS was mesenteric ischemia (73%). Of these patients, 67% had some risk factor associated with atherosclerosis. No significant differences in eating habits were detected between the period before and after surgery. After surgery, 39% of the patients developed a significant weight loss and 79% developed some type of complication, surgical in 34%, infectious in 66% and of both types in 21%. Survival was 9.5 years. Conclusion: Extensive resections of the small bowel may be associated with atherosclerosis and represent an important nutritional risk, with a significant weight loss during the first year, which seems to be related to increased morbidity. Adequate nutritional therapy is associated with increased survival.

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Hospital malnutrition and its consequences

HIGHER SCHOOL’S PULSE ◽

10.5604/01.3001.0003.4329 ◽

2015 ◽

Vol 9 (2) ◽

pp. 32-35

Author(s):

Elżbieta Szlenk-Czyczerska

Keyword(s):

Public Health ◽

Developing Countries ◽

Nutritional Status ◽

Public Health Problem ◽

Nutritional Therapy ◽

Hospital Malnutrition ◽

Nutritional Conditions ◽

Basic Functions ◽

Widespread Phenomenon ◽

Increased Susceptibility

Nutrition is one of the basic functions of the human body. The shortage of food, as well as lack of oxygen or water, leads to death, however, it takes longer to cause death. Prolonged hunger or excessive intensity of metabolic processes may lead to the state known as malnutrition. It is characterized by the decrease of immunity and increased susceptibility to diseases which consequently may also cause the increase of mortality. Malnutrition is now a public health problem in both developed and developing countries. Hospital malnutrition is a widespread phenomenon which encourages the development of complications as well as results in prolonged hospitalization and the increase of the treatment costs. The consequences of malnutrition affect all the organs and systems, including human psychomotor abilities. The main purpose of screening the nutritional conditions is to assess the nutritional status of patients who appear to be at risk of malnutrition at the early stadium. It, secondarily, also aims at identifying patients with specific indications for nutritional therapy.

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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 ◽

10.3390/nu13010263 ◽

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.

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Nutritional Status of COVID 19 Patients: Possible Impact on Mental Health Status

Current Developments in Nutrition ◽

10.1093/cdn/nzab029_016 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 215-215

Author(s):

Ahlam el Shikieri ◽

Ahmad Hafiz

Keyword(s):

Mental Health ◽

Weight Loss ◽

Health Status ◽

Food Intake ◽

Nutritional Status ◽

Mental Health Status ◽

Related Factors ◽

Severity Of Depression ◽

Loss Of Appetite ◽

The Impact

Abstract Objectives To assess the impact of the nutritional status of COVID-19 patients on their mental health status. It is hypothesized that patients would have impaired mental health status due to compromised nutritional status Methods An epidemiological, cross-sectional study included acute-severely ill COVID-19 patients in Al Madinah Al Munawarah, Saudi Arabia. The following parameters were assessed: demographic characteristics, nutritional status (using the Malnutrition Screening Tool), BMI, loss of appetite, weight loss, decreased food intake and mental health status (using the PHQ-9 to determine the severity of depression). Data collectors wore Personal Protective Equipment and spent a maximum of 15 minutes with each patient. Ethical approval was obtained from the Ministry of Health as well as patients. Statistical analysis was performed using SPSS version 26. Results Patients (n = 515; 82% males) were included. They aged 31–50 years old (60%), married (85%), had low education level (85%), employed in non-governmental sectors (67%), and were non-Saudis (76%). Patients complained of loss of appetite (32%), weight loss (16%), and decreased food intake (19%). A significant number were at risk (13.6%) and 1.6% had high risk of malnutrition. Patients (4%) were underweight and 45% were overweight and/or obese. The mean BMI was 25.4 (SD = 5). They (23.4%) suffered from various degrees of depression. Mild depression was most prevalent (17%) followed by moderate depression (4.3%). Moderately severe and severe depression were common among 2.1%. One way ANOVA indicated that the severity of depression associated with the loss of appetite (P < 0.0005), decreased food intake (P < 0.0005), weight loss (P < 0.0005), and BMI (P < 0.0005). Linear Multiple Regression showed that the loss of appetite (B = 0.037, 95%CI = 0.011–0.352, P = 0.037), weight loss (B = 0.114, 95%CI = 0.000–0.228, P = 0.0049), and BMI (B = 0.031, 95%CI = 0.004–0.057, P = 0.023) affected patients' severity of depression. Conclusions Possible factors associated with depression included loss of appetite, decreased food intake, weight change and BMI. Early detection of malnutrition-related factors and depression reduces hospital stay and cost of medication. It speeds up the rate of recovery, improves health outcomes and the quality of life. Funding Sources No funding was received.

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Score of “eat-ability” as a predictor of malnutrition in patients with gastrointestinal tract cancer: a pilot study

Nutrición Hospitalaria ◽

10.20960/nh.1668 ◽

2018 ◽

Author(s):

TAIANE DIAS BARREIRO

Keyword(s):

Weight Loss ◽

Gastrointestinal Tract ◽

Pilot Study ◽

Food Intake ◽

Roc Curves ◽

Assessment Tools ◽

Cross Sectional ◽

Tract Cancer ◽

Risk Assessment Tools ◽

Loss Of Appetite

ABSTRACT Introduction: Decreased food intake, loss of appetite, and dysphagia are relevant symptoms in patients with gastrointestinal tract (GIT) cancer. However, these symptoms have been isolated or indirectly assessed when comprising quality of life questionnaires or risk assessment tools. Objective: To determine whether a combined assessment of dysphagia, appetite and food intake may be used as a parameter of eat-ability (food capacity) in patients with GIT cancer.Methods: A cross-sectional pilot study on 41 patients with GIT cancer were evaluated using a score for “eat-ability” (SEA) as compared to Patient Generated Subjective Global Assessment (PG-SGA), anthropometry and laboratory profile.Results: 11 (27%) patients had full eat-ability (SEA 0), 3 (7%) had moderate (SEA 1) and 27 (66%) had poor (SEA ≥2) eat-ability, which were significantly different, between upper and lower GIT tumours (p≤ 0.05). By ROC curves, SEA 1 and ≥2 showed an 80% for both sensibility (95%CI: 0.48-0.95) and specificity (95%CI: 0.63-0.91) to PG-SGA (A and B) with an area under curve (AUC) of 0.79 (95%CI: 0.64-0.95); p=0.006. Patients with SEA ≥2 had a significantly weight loss within 3 (p=0.001) and 6 months (p<0.001) when compared to patients with SEA 0 and 1. Mortality was also significantly higher (p=0.01) among patients with critical food capacity by SEA (77%) in severely unnourished patients by PG-SGA (84%).Conclusion: By combining food intake, dysphagia and appetite assessment altogether, a reliable score clearly demonstrated compromised eating capacity affecting nutritional status of patients with GIT tumours at a higher risk for death. Keywords: Dysphagia, Food Intake, Appetite, Unnourished, Gastrointestinal Cancer, Weight Loss.

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Métodos de triagem nutricional em pacientes ginecológicas hospitalizadas

Abr-Jun - Braspen Journal ◽

10.37111/braspenj.2020354004 ◽

2021 ◽

Vol 4 (35) ◽

pp. 345-350

Author(s):

Amanda da Silva Paiva ◽

Larissa Gens Guilherme ◽

Maria Goretti Pessoa de Araújo Burgos

Keyword(s):

Public Health Problem ◽

The Elderly ◽

Screening Tools ◽

Nutritional Risk ◽

Cross Sectional ◽

Nutrition Screening ◽

Hospital Malnutrition ◽

Significant Public Health ◽

Nrs 2002 ◽

The Individual

Introduction: Hospital malnutrition is characterized as a significant public health problem, so nutrition screening stands out as a prior tool to identify the individual at nutritional risk or malnourished, enabling a more appropriate intervention. Methods: Cross-sectional descriptive study, where three nutritional screening tools were used: ASG, Nutritional Risk Screening-2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), applied in the first 48 hours of hospital admission by the same researcher. Results: 150 women aged 42,69 ±11,84 years (20 - 83 years) were evaluated, in adults the major diagnosis was myomatosis (70%) and elderly, gynecological malignancies (50%). Most adults did not have associated comorbidities (80%), while arterial hypertension was the most prevalent in the elderly (30%). MUST detected 41.3% nutritional risk, while NRS-2002 only 21.3%. Comparing the MUST and NRS-2002 with the ASG as gold standard, the greatest sensitivity occurred with the MUST (42.4%), Kappa 3,4%. Conclusion: MUST showed greater sensitivity to detect nutritional risk in this population and had significantly shorter application time.

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