Risk Factors for Hospital Malnutrition Alike Worldwide

A new study reveals a set of factors associated with full meal intake that is applicable to patients hospitalized in any region of the world.

Researchers at the Medical University of Vienna (Austria), Geneva University Hospital (HUG; Switzerland), and other institutions conducted a descriptive analysis of 9 consecutive, annual, and cross-sectional nutritionDay samples, involving a total of 91,245 adult patients in 6,668 wards, in 2,584 hospitals, in 56 countries. The objective of the study was to evaluate the main factors associated with reduced meal intake in hospitalized patients, and the differences between geographical regions.

The findings revealed that the proportion of patients who ate a full meal varied widely (24.7–61.5%) across world regions. The factors most strongly associated with malnutrition were reduced intake during the previous week, confinement to bed, female sex, younger (below 49) and older (over 79) years of age, and low body mass index (BMI). The pattern of associated factors was homogenous across world regions with practically equal importance everywhere. The study was published in November 2016 issue of The American Journal of Clinical Nutrition.

“The excuse that patients often give that ‘I am ill so I'm not eating,’ or even ‘that's good, at least I'm losing weight’ are not acceptable and are bad for their prognosis. These risk groups need special attention. Ensuring that patients receive adequate nutrition should therefore be part of an holistic treatment plan,” said lead author nutritional expert Karin Schindler, PhD, of the Medical University of Vienna. “On the other hand, we must bear in mind that 50-60% of patients do not eat all of a meal that is offered, and this reduced food intake is rarely offset by nutritional care.”

"Patients' eating behavior should be systematically evaluated on admission to hospital. The simple questions are quick to ask and easy to answer. It should be explained to patients why it is important to eat,” concluded Dr. Schindler. “It might also be worth considering structural adaptations, such as the possibility of offering smaller portions or highly nutritious snacks between meals or special individual meals. In addition to that, it can be helpful to involve relatives in encouraging them to eat.”

Related Links:
Medical University of Vienna
Geneva University Hospital