The Trend of Malnutrition Frequency among Imam Reza Teaching Hospital: Results from Nutrition Day 2019-2021

Document Type : Research Paper

Authors

1 Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of community medicine, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.

3 International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Transplant Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Malnutrition is a global health issue that affects nearly forty percent of the population. Hospital malnutrition is a severe medical problem that is often overlooked and has negative impacts on both patients' health and the economy. Additionally, malnutrition increases the risk of clinical complications and mortality. On Nutrition Day (nDay), patients in hospital wards and nursing homes worldwide participate in a cross-sectional survey to assess their nutritional status using a standard questionnaire. This study aims to investigate the prevalence of malnutrition among patients at Imam Reza Teaching Hospital from 2019 to 2021. Method: This study analyzed nDay data from Mashhad’s Imam Reza Teaching Hospital from 2019 to 2021. The study included demographic and nutritional data from patients in fourteen different wards/units of the hospital. By examining patient-reported responses to questions about malnutrition and its risk factors, we present an overview of malnutrition trends over the past three years. Results: The frequency of malnutrition in Burn units was highest at 37.5% in the male unit in 2020 (P-value: < 0.0001). The lowest BMI was observed in Oncology patients, averaging 18.9±2.4 in 2019. The most significant decrease in nutritional intake occurred in the Gastroenterology department, at 37.5% in 2019. The highest change in hospital nutrition intake one week before admission was in the General Surgery ward, with a 47.4% decrease in 2019. Conclusion: Considering the significance of malnutrition, particularly in hospitals, utilizing nDay as a standard questionnaire and screening tool could assist the health system in addressing this issue. Our study of malnutrition trends in Mashhad teaching hospitals from 2019 to 2021 indicates that Burn units, Gastroenterology, Oncology, and General Surgery departments are the most susceptible to malnutrition and thus require increased attention.

Keywords

Main Subjects


  1. Wells JC, Sawaya AL, Wibaek R, Mwangome M, Poullas MS, Yajnik CS, et al. The double burden of malnutrition: aetiological pathways and consequences for health. The Lancet. 2020;395(10217):75-88.
  2. Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, et al. The global syndemic of obesity, undernutrition, and climate change: the Lancet Commission report. The lancet. 2019;393(10173):791-846.
  3. Crichton M, Craven D, Mackay H, Marx W, De Van Der Schueren M, Marshall S. A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex. Age and ageing. 2019;48(1):38-48.
  4. Fleming TP, Watkins AJ, Velazquez MA, Mathers JC, Prentice AM, Stephenson J, et al. Origins of lifetime health around the time of conception: causes and consequences. The Lancet. 2018;391(10132):1842-52.
  5. Kiesswetter E, Colombo MG, Meisinger C, Peters A, Thorand B, Holle R, et al. Malnutrition and related risk factors in older adults from different health-care settings: an enable study. Public health nutrition. 2020;23(3):446-56.
  6. Besora-Moreno M, Llauradó E, Tarro L, Solà R. Social and economic factors and malnutrition or the risk of malnutrition in the elderly: a systematic review and meta-analysis of observational studies. Nutrients. 2020;12(3):737.
  7. Correia MIT, Sulo S, Brunton C, Sulz I, Rodriguez D, Gomez G, et al. Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results. Clinical Nutrition. 2021;40(9):5114-21.
  8. Inciong JFB, Chaudhary A, Hsu H-S, Joshi R, Seo J-M, Trung LV, et al. Hospital malnutrition in northeast and southeast Asia: A systematic literature review. Clinical Nutrition ESPEN. 2020;39:30-45.
  9. Lovesley D, Parasuraman R, Ramamurthy A. Combating hospital malnutrition: Dietitian-led quality improvement initiative. Clinical Nutrition ESPEN. 2019;30:19-25.
  10. Trtovac D, Lee J. The use of technology in identifying hospital malnutrition: scoping review. JMIR medical informatics. 2018;6(1):e4.

11..

  1. Serón-Arbeloa C, Labarta-Monzón L, Puzo-Foncillas J, Mallor-Bonet T, Lafita-López A, Bueno-Vidales N, et al. Malnutrition Screening and Assessment. Nutrients. 2022;14(12).
  2. Leij-Halfwerk S, Verwijs MH, van Houdt S, Borkent JW, Guaitoli PR, Pelgrim T, et al. Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults ≥65 years: A systematic review and meta-analysis. Maturitas. 2019;126:80-9.
  3. Böhne SEJ, Hiesmayr M, Sulz I, Tarantino S, Wirth R, Volkert D. Recent and current low food intake – prevalence and associated factors in hospital patients from different medical specialities. European Journal of Clinical Nutrition. 2022;76(10):1440-8.
  4. Tarantino S, Hiesmayr M, Sulz I. nutritionDay Worldwide Annual Report 2019. Clinical Nutrition ESPEN. 2022;49:560-667.
  5. Poudineh S, Shayesteh F, Kermanchi J, Haghdoost AA, Torabi P, Pasdar Y, et al. A multi-centre survey on hospital malnutrition: result of PNSI study. Nutr J. 2021;20(1):87.
  6. Williams FN, Herndon DN, Jeschke MG. The hypermetabolic response to burn injury and interventions to modify this response. Clin Plast Surg. 2009;36(4):583-96.
  7. Chan MM, Chan GM. Nutritional therapy for burns in children and adults. Nutrition. 2009;25(3):261-9.
  8. Clark A, Imran J, Madni T, Wolf SE. Nutrition and metabolism in burn patients. Burns & trauma. 2017;5.
  9. Yu YM, Tompkins RG, Ryan CM, Young VR. The metabolic basis of the increase in energy expenditure in severely burned patients. Journal of Parenteral and Enteral Nutrition. 1999;23(3):160-8.
  10. Williams FN, Herndon DN, Jeschke MG. The hypermetabolic response to burn injury and interventions to modify this response. Clinics in plastic surgery. 2009;36(4):583-96.
  11. Demling RH, Seigne P. Metabolic management of patients with severe burns. World journal of surgery. 2000;24:673-80.
  12. Magnotti LJ, Deitch EA. Burns, bacterial translocation, gut barrier function, and failure. The Journal of burn care & rehabilitation. 2005;26(5):383-91.
  13. Graves C, Saffle J, Morris S. Comparison of urine urea nitrogen collection times in critically ill patients. Nutrition in clinical practice. 2005;20(2):271-5.
  14. Law ML. Cancer cachexia: Pathophysiology and association with cancer-related pain. Frontiers in Pain Research. 2022;3:971295.
  15. Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, et al. Definition and classification of cancer cachexia: an international consensus. The lancet oncology. 2011;12(5):489-95.
  16. Del Fabbro E. Combination therapy in cachexia. Ann Palliat Med. 2019;8(1):59-66.
  17. Mantovani G, Macciò A, Madeddu C, Serpe R, Massa E, Dessì M, et al. Randomized phase III clinical trial of five different arms of treatment in 332 patients with cancer cachexia. The Oncologist. 2010;15(2):200-11.
  18. Wu Q, Liu Z, Li B, Liu Y-e, Wang P. Immunoregulation in cancer-associated cachexia. Journal of Advanced Research. 2023.
  19. Fromhold-Treu S, Lamprecht G. [Gastrointestinal causes of weight loss: clinical presentation, diagnostic workup and therapy]. Dtsch Med Wochenschr. 2016;141(4):253-60.
  20. Sawczenko A, Sandhu B. Presenting features of inflammatory bowel disease in Great Britain and Ireland. Archives of disease in childhood. 2003;88(11):995-1000.
  21. Elsherif Y, Alexakis C, Mendall M. Determinants of Weight Loss prior to Diagnosis in Inflammatory Bowel Disease: A Retrospective Observational Study. Gastroenterol Res Pract. 2014;2014:762191.
  22. Rigaud D, Cerf M, Sobhani I, Carduner M, Mignon M. Increase of resting energy expenditure during flare-ups in Crohn disease. Gastroenterologie Clinique et Biologique. 1993;17(12):932-7.
  23. Karmiris K, Koutroubakis IE, Kouroumalis EA. Leptin, adiponectin, resistin, and ghrelin–implications for inflammatory bowel disease. Molecular nutrition & food research. 2008;52(8):855-66.
  24. Konturek PC, Herrmann HJ, Schink K, Neurath MF, Zopf Y. Malnutrition in hospitals: it was, is now, and must not remain a problem! Medical science monitor: international medical journal of experimental and clinical research. 2015;21:2969.
  25. Stratton RJ, Hackston A, Longmore D, Dixon R, Price S, Stroud M, et al. Malnutrition in hospital outpatients and inpatients: prevalence, concurrent validity and ease of use of the ‘malnutrition universal screening tool’(‘MUST’) for adults. British Journal of Nutrition. 2004;92(5):799-808.
  26. Vidal A, Iglesias MJ, Pertega S, Ayúcar A, Vidal O. Prevalence of malnutrition in medical and surgical wards of a university hospital. Nutrición Hospitalaria. 2008;23(3):263-7.

Articles in Press, Accepted Manuscript
Available Online from 24 June 2024
  • Receive Date: 12 May 2024
  • Revise Date: 20 June 2024
  • Accept Date: 24 June 2024