Skip to main content
  • Original article
  • Open access
  • Published:

High prevalence of malnutrition among hospitalized patients in a tertiary care hospital by using malnutrition universal screening tool

En

Abstract

Background

Estimating the prevalence of malnutrition among the hospitalized patients is challenging. Malnutrition is associated with a variety of poor outcomes including long hospital stay and mortality as well as increased hospital costs.

Aim

The study aims to assess the risk of malnutrition in hospitalized patients and to identify the main factors and clinical parameters associated with the risk of malnutrition.

Materials and methods

The researchers conducted a cohort study to screen for the risk of malnutrition following hospital admission in a population of adult patients recently admitted to a tertiary care hospital in Egypt using the malnutrition universal screening tool (MUST) and simplified nutritional appetite questionnaire and to assess the effect of malnutrition on duration of hospital stay.

Results

The study included 1000 patients with a mean age of 49±13.7 years. The median duration of hospitalization was 5 (4–7) days, with a range of 2–30 days. All those included in the study presented a risk for malnutrition (1.0% medium risk and 99.0% high risk). High risk malnutrition was most common among those with diabetes (P=0.001) and renal problems (P=0.03), and in patients who had been admitted for longer hospital stay (P=0.037). A statistically positive correlation was seen between the age of the patients (P=0.031, r=−0.031), length of stay (P=0.353, r<0.001), and MUST score. However, there was a statistically significant negative weak correlation between simplified nutritional appetite questionnaire (appetite) (P=0.003, r=−0.094), BMI (P<0.001, r=−0.120), albumin (P<0.001, r=−0.117), and MUST score. Malnourished patients had a longer hospital stay than those who are well nourished (P=0.002).

Conclusion

We have identified an overall malnutrition risk of 100% among the hospitalized patients and ascertained that malnutrition is a risk of prolonged length of hospital stay. MUST questionnaire should be implemented to screen and early recognize the malnourished hospitalized subjects for better intervention.

References

  1. The Prague Declaration: stop disease-related malnutrition. Available at: http://www.european-nutrition.org/index.php/topics/prague. [Accessed 4 March 2018].

  2. Korfalii G, Guündogdu H, Aydintg S, Bahar M, Besler T, Moral AR et al. Nutritional risk of hospitalized patients in Turkey. Clin Nutr 2009; 28: 533–537.

    Article  Google Scholar 

  3. Kruizenga H, Van Keeken S, Weijs P, Luc B, Sandra B, Getty H et al. Undernutrition screening survey in 564,063 patients: patients with a positive undernutrition screening score stay in hospital 1.4 d longer. Am J Clin Nutr 2016; 103:1026–1032.

    Article  CAS  Google Scholar 

  4. Budzyński J, Tojek K, Czerniak B, Zbigniew B. Scores of nutritional risk and parameters of nutritional status assessment as predictors of in-hospital mortality and readmissions in the general hospital population. Clin Nutr 2016; 35: 1464–1471.

    Article  Google Scholar 

  5. Lim SL, Ong KC, Chan YH, Oke WC, Ferguson M, Daniels L. Malnutrition and its impact on cost of hospitalization, length of stay, readmission and 3-year mortality. Clin Nutr 2012; 31: 345–350.

    Article  Google Scholar 

  6. Löser C. Malnutrition in hospital: the clinical and economic implications. Dtsch Arztebl Int 2010; 107: 911–917.

    PubMed  PubMed Central  Google Scholar 

  7. Corkins MR, Guenter P, DiMaria-Ghalili RA, Gordon L, Ainsley M, Sarah M et al. Malnutrition diagnoses in hospitalized patients. J Parenter Enteral Nutr 2014; 38: 186–195.

    Article  Google Scholar 

  8. Todorovic V, Russell C, Stratton R, Ward J, Elia M. The ‘MUST’ explanatory booklet. 1st ed. Redditch: BAPEN; 2003.

    Google Scholar 

  9. Wilson MM, Thomas DR, Rubenstein LZ, Chibnall JT, Anderson S, Baxi A et al. Appetite assessment: simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr 2005; 82: 1074–1081.

    Article  CAS  Google Scholar 

  10. Rabito EI, Marcadenti A, da Silva Fink J, Figueira L, Silva FM. Nutritional Risk Screening 2002, Short Nutritional Assessment Questionnaire Malnutrition Screening Tool, and Malnutrition Universal Screening Tool Are Good Predictors of Nutrition Risk in an Emergency Service. Nutr Clin Pract 2017; 23:526–532.

    Article  Google Scholar 

  11. Vashi PG, Gupta D, Lammersfeld C, Braun D, Popiel B, Misra S et al. The relationship between baseline nutritional status with subsequent parenteral nutrition and clinical outcomes in cancer patients undergoing hyperthermic intraperitoneal chemotherapy. Nutr J 2013; 12: 118.

    Article  Google Scholar 

  12. Smith RE. The clinical and economic burden of anemia. Am J Manag Care 2010; 16: S59–S66.

    PubMed  Google Scholar 

  13. IBM. Corp. IBM SPSS Statistics for Windows (Version 21.0.). Armonk, NY: IBM Corp; 2012.

    Google Scholar 

  14. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310:2191–2194

    Article  Google Scholar 

  15. Starke J, Schneider H, Alteheld B, Stehle P, Meier R. Short-term individual nutritional care as part of routine clinical setting improves outcome and quality of life in malnourished medical patients. Clin Nutr 2011; 30: 194–201.

    Article  Google Scholar 

  16. Álvarez-Hernández J, Planas Vila M, León-Sanz M, García de Lorenzo A, Celaya-Pérez S, García-Lorda P et al.; PREDyCES researchers. Prevalence and costs of malnutrition in hospitalized patients; the PREDyCES Study. Nutr Hosp 2012; 27:1049–1059.

    PubMed  Google Scholar 

  17. Kubrack C, Jensen L. Malnutrition in acute care patients. Int J Nurs 2007; 44: 1036–1054.

    Article  Google Scholar 

  18. Raslan M, Gonzalez MC, Dias MC, Nascimento M, Castro M, Margues P et al. Comparison of nutritional risk screening tools for predicting clinical outcomes in hospitalized patients. Nutrition 2010; 26: 721–726.

    Article  Google Scholar 

  19. Zhang L, Wang X, Huang Y, Gao Y, Peng N, Zhu W et al. Nutrition Day 2010 audit in Jinling hospital of China. Asia Pac J Clin Nutr 2013; 22: 206–213.

    PubMed  Google Scholar 

  20. Philipson T, Thornton Sinder J, Lakdawalla D, Stryckman B, Goldman D. Impact of oral nutritional supplementation on hospital outcomes. Am J Manag Care 2017; 19: 121–128.

    Google Scholar 

  21. Nițescu M, Furtunescu FL, Pițigoi D, Streinu-Cercel A, Săndulescu O, Oțelea MR et al. Screening for malnutrition risk at hospital admission in patients with infectious diseases. J Contemp Clin Pract 2017; 3: 57–63.

    Google Scholar 

  22. Agarwal E, Ferguson M, Banks M, Batterham M, Bauer J, Capra S et al. Nutrition care practises in hospital wards: results from the Nutrition Care Day Survey 201. Clin Nutr 2012; 31: 995–1001.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mervat E. Behiry MD of Internal Medicine.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Behiry, M.E., Salem, M.R. High prevalence of malnutrition among hospitalized patients in a tertiary care hospital by using malnutrition universal screening tool. Egypt J Intern Med 31, 326–331 (2019). https://doi.org/10.4103/ejim.ejim_126_18

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejim.ejim_126_18

Keywords