Abstract
Patients with undernutrition at admission have higher risks to worsen their nutritional status, which is linked to an increase in morbidity and mortality. This study investigated the prevalence of undernutrition at admission and its associated factors. A cross-sectional study was conducted on patients aged 18 to 59 years old in Internal Medicine ward at Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia, between July and September 2019. Factors that might be associated with undernutrition at admission, such as age, sex, marital status, Charlson Comorbidity Index (CCI) and type of comorbidity, depression, and neutrophil–lymphocyte ratio (NLR), were assessed. Bivariate and multivariate analyses were used to determine the associated factors. Sixty hospitalized patients with median age of 42 years and 76.7% with married status joined the study. The most common reason for hospitalization was acute gastrointestinal disease with gallstones as the most common comorbidity. Undernutrition exists in 26.7% of subjects. High CCI score was observed among 11.7% subjects and half of subjects had NLR category ≥5. Bivariate analysis revealed that unmarried status, age ≥40 years, and malignancy were associated with undernutrition at admission. Logistic regression analysis showed malignancy as an independent predictor of undernutrition during the initial hospital admission (odds ratio [OR] = 11.8; 95% confidence interval [CI]: [1.1, 125.7]). The prevalence of undernutrition at admission was 26.7%. Factors associated with an increased prevalence of undernutrition at admission were age <40 years, unmarried status, and malignancy. Malignancy was an independent factor of the prevalence of undernutrition at admission.
Highlights
Hospital malnutrition remains a global problem, with reported prevalence rates varying between 20.0% and 65.5% (Barker et al, 2011; Syam et al, 2018)
This study aims to assess the prevalence of undernutrition at admission among Internal Medicine patients in Indonesia and its association with age, sex, marital status, type of comorbidity, depression, Charlson Comorbidity Index (CCI), and neutrophil–lymphocyte ratio (NLR)
Study subjects underwent a series of assessments including demographic data, medical interviews to look for patient’s diseases, Beck Depression Inventory (BDI)-II Indonesia to detect depression (Ginting et al, 2013), BMI to determine nutritional status, CCI to know the existence of comorbidity, and NLR
Summary
Hospital malnutrition remains a global problem, with reported prevalence rates varying between 20.0% and 65.5% (Barker et al, 2011; Syam et al, 2018). Global Leadership Initiative on Malnutrition (GLIM) defines malnutrition as a combination of one phenotypic criteria (non-volitional weight loss, low body mass index [BMI], or reduced muscle mass) and one etiologic criteria (reduced food intake or inflammation/disease burden) (Cederholm et al, 2019). This condition is related to an increased number of morbidity and mortality, prolonged hospitalization, and an increased cost of care; early identification of nutritional status is important for all hospitalized patients (Correia & Waitzberg, 2003).
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