Prevalence Of Nutritional Risk Research Articles

A multicentre assessment of malnutrition, nutritional risk, and application of nutritional support among hospitalized patients in Guangzhou hospitals.

To assess nutritional status, the prevalence of nutritional risk, and nutritional support in hospitalized patients in Guangzhou, to determine gender or age associated differences in the prevalence of nutritional risk. A total of 2550 patients admitted during April to December 2008 from six departments (Gastroenterology, Pulmonology, Neurology, Nephrology, General Surgery and Thoracic Surgery) of four teaching hospitals were screened using the Nutritional Risk Screening 2002 tool. Overall prevalence of undernutrition and nutritional risk was 17.8% and 41.5%, respectively. The department of Pulmonology had the highest prevalence of undernutrition (28.2%) and nutritional risk (55.9%). The prevalence of nutritional risk was significantly higher in patients >=70 years of age than patients <70 years (64.2% vs 32.6%, p<0.001). No gender difference in the prevalence of nutritional risk was observed in general. In total, 47.6% of "at risk" and 19.4% of "not at risk" patients received nutritional support. Parenteral nutrition accounted for 88.8% of the nutritional support. The present study documented the prevalence of nutritional risk defined by NRS2002 and inappropriate assignment of nutritional interventions in Guangzhou hospitals.

Prevalence of nutritional risks, malnutrition and application of nutritional support rates at one Chongqing teaching hospital

To prospectively explore the prevalence of nutritional risks and undernutrition, obesity and the application of nutritional support in First Affiliated Hospital of Chongqing Medical University and compare the data with those of big hospitals in Beijing. A total of 2255 inpatients from the department of gastroenterology, gastrointestinal surgery, neurology and respiratory medicine at our hospital were consecutively recruited from June to October 2011. Nutritional Risk Screening 2002 (NRS2002) was performed at 24 h post-admission. And nutritional support was examined during the period of hospitalization. Among them, 2166 patients (96.1%) received NRS2002. The overall prevalence of nutritional risk was 29.5% (638/2166), undernutrition 12.2% (265/2166) and the incidence of obesity 2.4% (52/2166). For the patients at nutritional risks, only 9.2% (59/638) of them received nutrition support. The nutrition support of gastrointestinal surgery department was higher than Beijing, and that of neurology department was lower than Beijing. For those not at nutritional risks, 1.0% (16/1528) received nutritional support. And that of 4 department were all lower than Beijing (all P < 0.01). The nutritional risk patients on nutritional support rates is lower at First Affiliated Hospital of Chongqing Medical University and excessive use of parenteral nutrition support seems routine. The Chinese Society for Parenteral and Enteral Nutrition (CSPEN) guidelines of rational nutrition support should be vigorously promoted.

Nutritional risk and gastrointestinal dysautonomia symptoms in Parkinson's disease outpatients hospitalised on a scheduled basis

Dysautonomia symptoms of nutritional interest may often occur in Parkinson's disease (PD), but the role played in affecting the risk of malnutrition still needs to be clarified. A total of 208 consecutive PD outpatients hospitalised on a scheduled basis were assessed for nutritional risk by the Malnutrition Universal Screening Tool. Presence of dysautonomia symptoms (dysphagia, sialorrhoea and constipation) was investigated using clinical rating scales. In our population, prevalence of nutritional risk was 17·2 (95 % CI 12·1, 24·0) % and relied mainly on unintentional weight loss. Sialorrhoea, dysphagia, dysphagia to liquids and constipation were observed in 10·6, 11·0, 14·4 and 59·6 % of the patients, respectively. Nutritional risk was independently associated with the number of dysautonomia symptoms (OR 1·39 (95 % CI 1·00, 1·96); P= 0·048) but not with single symptoms. An independent association was also found with the severity of motor symptoms (Hoehn-Yahr stage, OR 1·48 (95 % CI 1·00, 2·55); P= 0·049) and levodopa dose (OR 1·16 (95 % CI 1·04, 1·31) mg/kg per d; P= 0·009). Nutritional risk in PD outpatients appears to depend mainly on dysautonomic syndrome, disease severity and levodopa dosage. Implications for outcome deserve further investigation. The assessment of nutritional status and of gastrointestinal dysautonomia symptoms should be part of the routine work-up of a PD patient.

Nutritional screening of older home-dwelling Norwegians: a comparison between two instruments

BackgroundIt is important to obtain knowledge about the prevalence of nutritional risk and associated factors among older home-dwelling people in order to be able to meet nutritional challenges in this group in the future and to plan appropriate interventions. The aim of this survey was to investigate the prevalence of home-dwelling older people at nutritional risk and to identify associated factors using two different nutritional screening instruments as self-report instruments.MethodsThis study had a cross-sectional design. A postal questionnaire, including the Norwegian versions of the Nutritional Form for the Elderly (NUFFE-NO) and Mini Nutritional Assessment – Short Form (MNA-SF), background variables, and health-related questions was sent to a randomized sample of 6033 home-dwelling older people in southern Norway. A total of 2106 (34.9%) subjects were included in the study. Data were analyzed using descriptive statistics and logistic regression analyses.ResultsWhen using the NUFFE-NO and MNA-SF, 426 (22.3%) and 258 (13.5%) older persons, respectively, were identified to be at nutritional risk. The risk of undernutrition increased with age. Several predictors for being at risk of undernutrition, including chronic disease/handicap and receiving family help, as well as protective factors, including sufficient food intake and having social contacts, were identified.ConclusionHealth professionals must be aware of older people’s vulnerability to risk of undernutrition, perform screening, and have a plan for preventing under-nutrition. For that purpose, MNA-SF and NUFFE-NO can be suggested for screening older people living at home.

Nutritional and psychosocial status of colorectal cancer patients referred to an outpatient oncology clinic

Malnutrition and psychological distress are associated with poorer outcomes following treatment for colorectal cancer. Screening for issues such as malnutrition, depression, and anxiety is being adopted in some oncology settings, but its effectiveness or the relationship between these risk factors in this population are not well understood. A retrospective chart review was conducted of 836 health assessment forms provided to colorectal cancer patients referred to an outpatient oncology clinic. Nutritional (Patient-Generated Subjective Global Assessment) and psychological (Psychosocial Screen for Cancer) screening tools were included in the form. Demographic and screening tool information was obtained from completed forms. The prevalence of nutritional risk, depression, and anxiety were determined based on screening tool scores and clinical cutoffs. An ordinal regression model was fitted to determine which demographic and psychosocial factors best predicted nutritional risk. Only 252 (30%) of the forms were completed enough for inclusion in analysis. The prevalence of nutritional risk, anxiety, and depression were determined to be 29%, 10%, and 7%, respectively. A regression model containing the variables depression, anxiety, gender, health coverage, and marital status was found to best explain the nutritional score. Depression was the most significant predictor, with odds of increased nutritional risk being 5.6 times greater for depressed individuals (P = 0.0005). The use of nutritional and psychosocial screening tools is warranted and needs to be emphasized more in oncology settings. There appears to be a relationship between psychosocial issues and increased nutritional risk which should be taken into account when considering cancer care interventions.

Comparison of four nutritional screening tools to detect nutritional risk in hospitalized patients: a multicentre study

The prevalence of malnutrition in hospitals is high. No nutritional screening tool is considered the gold standard for identifying nutritional risk. The aims of this study were to evaluate nutritional risk in hospitalized patients using four nutritional screening tools. Four nutritional screening tools were evaluated: nutritional risk screening (NRS-2002), the malnutrition universal screening tool (MUST), the subjective global assessment (SGA) and the mini nutritional assessment (MNA). Patients were assessed within the first 36 h after hospital admission. Date of admission, diagnosis, complications and date of discharge were collected. To compare the tools, the results were reorganized into: patients at risk and patients with a good nutritional status. The statistical analysis included the χ(2)-test to assess differences between the tests and the κ statistic to assess agreement between the tests. The study sample comprised 400 patients (159 women, 241 men), mean age 67.3 (16.1) years. The prevalence of patients at nutritional risk with the NRS-2002, MUST, SGA and MNA was 34.5, 31.5, 35.3 and 58.5%, respectively. Statistically significant differences were observed between the four nutritional screening tools (P<0.001). The agreement between the tools was quite good except for the MNA (MNA-SGA κ=0.491, NRS-2002-SGA κ=0.620 and MUST-SGA κ=0.635). Patients at nutritional risk developed more complications during admission and had an increased length of stay. The prevalence of nutritional risk in hospitalized patients was high with all the tools used. The best agreement between the tools was for NRS-2002 with SGA and MUST with SGA. At admission, NRS-2002 and MUST should be used to screen for nutritional status.

Fluid intake and nutritional risk in non-critically ill patients at hospital referral

The association between hyporexia/anorexia, reduced food intake and disease-related malnutrition at hospital admission is well established. However, information on fluid intake according to nutritional risk has never been provided. Thus, we assessed the attitude and adequacy of fluid intake among case-mix hospitalised patients according to nutritional risk. A sample of 559 non-critically ill patients randomly taken from medical and surgical wards was evaluated. Nutritional risk was diagnosed by the Nutritional Risk Screening 2002. Usual fluid consumption the week before admission was assessed and categorised as < 5 and > or = 5 cups/d (1 cup = 240 ml), with the acceptable intake being > or = 5 cups/d. Prevalence of nutritional risk was 57.2%, and 46.2% of the patients reported a fluid intake < 5 cups/d. Multiple-adjusted logistic regression revealed that age > or = 65 years (OR: 1.88 (95% CI: 1.03, 3.43); P < 0.04), energy intake (for every 25% increase in food intake compared with estimated requirements, OR: 0.37 (95% CI: 0.25, 0.55); P < 0.001) and the number of drugs taken (every three-drug increase, OR: 0.63 (95 % CI: 0.44, 0.90); P < 0.02) were independently associated with inadequate fluid intake (< 5 cups/d). A significant independent association was also found with nutritional risk (OR: 0.64 (95% CI: 0.43, 0.95); P < 0.03). Nutritional risk appears to be positively associated with greater fluid intake in non-acute hospitalised patients, but both the reasons and the consequences of this relationship, as well as the impact on clinical practice, need to be explored. However, water replacement by oral nutritional support should take advantage of the patients' attitude to assuming a greater fluid intake, limiting at the same time fluid overload during the refeeding phase.

Geriatric Nutritional Risk Index and overall-cause mortality prediction in institutionalised elderly: A 3-year survival analysis

A new tool, the Geriatric Nutritional Risk Index (GNRI), was recently proposed to predict short-term complications in elderly medical patients but no information is available when long-term follow-up periods are considered. A 3-year follow-up study in 245 institutionalised elderly (51 M:194 F; 83.7+/-8.6 years). Nutritional risk was graded by GNRI (severe, <82; moderate, 82 to <92; mild, 92-98; no risk, >98). Main outcome was overall-cause death. After the follow-up 99 (26 M:73 F) events occurred. Nutritional risk prevalence was 5.7%, 24.1%, 34.7% and 35.5% and mortality rates were 71.4%, 48.6% 33.7% and 34.3% with the GNRI<82, 82 to <92, 92-98, and >98, respectively. Kaplan-Meier curves were significantly associated to GNRI (p=0.0068). GNRI<82 was consistently related to death (odds ratio, OR=5.29, [95%CI: 1.43-19.57], p=0.0127) when compared to GNRI>98. Similar results were confirmed by Cox regression (hazard ratio, HR=2.76 [95%CI: 1.89-4.03], p=0.0072). Finally, when "severe" and "moderate" risk were analysed as a single class (GNRI<92) outcome associations were: OR=2.17, [95%CI: 1.10-4.28] (p=0.0245); HR=1.76 [95%CI: 1.34-2.23] (p=0.0315). Survival analysis showed higher mortality rates by GNRI<92 (p=0.0188). Present data support the use of the GNRI in the evaluation of long-term nutrition-related risk of death. We suggest a GNRI<92 as clinical trigger for nutritional support in institutionalised elderly.

Screening for nutrition risk in children: the validation of a new tool

Background: The importance of the early identification and management of nutritional risk is well established in adult and elderly hospital care. Numerous nutritional screening tools are available for adults, for example Malnutrition Universal Screening Tool (MUST), Mini Nutritional Assessment (MNA) and NRS‐2002 (Kondrup et al., 2003). Currently there is no validated nutrition risk screening tool for use with children admitted to hospital in the UK. The aim of this study was to test the validity of a newly developed nutrition risk screening tool for children.Methods: All children (aged 2–17 years) admitted to the study wards (two medical, two surgical) over a 4 week period were screened using a newly developed, nurse administered paediatric nutrition screening tool (NST). The NST consisted of three elements – clinical diagnosis, nutritional intake and anthropometric measures. Each element was scored and children with an overall score of three or more were considered at nutritional risk. Of those screened, a sample (n = 89) were further assessed for full nutritional status by a registered dietitian. The full nutritional assessment consisted of a face‐to‐face interview obtaining dietary and social information, anthropometric measurements and retrieval of medical information from case notes. Data were analysed using chi‐square tests to compare groups within the sample and k statistic to compare agreement between the full nutritional assessment and NST. Full ethical approval was obtained prior to undertaking this study.Results: The majority of 89 participants were surgical admissions (58%), male (56%) and the mean (SD) age was 9.0 (4.5) years. Nutritional risk was identified in 21% of the sample using the NST, and in 20% of the sample by full nutritional assessment. The prevalence of nutritional risk was not significantly different between methods or between males and females (by either method), but was statistically higher (by both methods) in medical compared with surgical admissions (χ2 = 18.426, P &lt; 0.001; χ2 = 7.139, P = 0.008 respectively). Compared to the full nutritional assessment, the NST demonstrated 72% sensitivity and 90% specificity and a k statistic (95% CI) of 0.599 (0.39, 0.81) (Table 1). Agreement between full nutritional assessment and the nutrition screening tool (NST) NST At nutrition risk (n) Not at nutrition risk (n) Full nutritional assessment At nutrition risk 13 5 Not at nutrition risk 7 64 Discussion: This study validated the use of a newly developed, nurse administered nutrition risk screening tool for children, utilising information normally obtained by nursing staff during the admission process thereby requiring little additional training. The tool demonstrated good agreement with a full nutritional assessment by a registered dietitian, indicating that it would be effective in the early identification of children at nutritional risk.Conclusion: The results suggest that this new nutrition risk screening tool is valid and reliable for the identification of children requiring further nutritional assessment and appropriate intervention. Further investigation will focus on the malnutrition risk by different clinical conditions.Reference Kondrup, J., Allison, J.P., Elia, M., Vellas, B. &amp; Plauth, M. (2003) ESPEN Guidelines for nutrition screening 2002.Clin. Nutr.22, 415–421.

Determinação de risco nutricional e desnutrição por antropometria em crianças e adolescentes com cirrose

The malnutrition is a frequent finding in adults with cirrhosis, but the prevalence of nutritional risk and malnutrition is little known in pediatric patients. To evaluate through anthropometry the presence of nutritional risk and malnutrition in cirrhotic pediatric patients regularly attended at the Pediatric Gastroenterology Service of "Hospital de Clínicas" of Porto Alegre, RS, Brazil. Cross-sectional study with 42 cirrhotic children and adolescents aged between 3 months and 18 years. The nutritional evaluation was made by the determination of the weight/age, height/age, body mass index and triceps skinfold thickness and arm muscle circumference measurements. Patients considered in nutritional risk were < or = -1,28 Z score which corresponds to < or = 10th percentile, and those under -2,0 Z and < or = 3th percentile were in malnutrition status. According to Child-Pugh criteria, 22 patients were classified as A (mild severity), 15 (moderate) B and 5 C (intense). The mean weight/age, height/age and body mass index Z scores were, respectively, - 0,38 +/- 1,4 SD, - 0,83 +/- 1,16 SD and 0,17 +/- 1,3 SD. Patients in nutritional risk were 3/42 (weight/age), 8/42 (height/age), 12/37 (triceps skinfold thickness), 9/37 (arm muscle circumference), 2/38 (body mass index); in malnutrition status were 6/42 (weight/age), 7/42 (height/age), 4/37 (triceps skinfold thickness) and 4/37 (arm muscle circumference) and 3/38 (body mass index). The prevalence of nutritional risk was 32.4% and chronic malnutrition was 16.7%. The index which better reflected the nutritional risk in these patients was triceps skinfold thickness. Chronic malnutrition status occurrence was greater in the height/age index.

Prevalence of Nutrition Risk in the Reconstructive Burn Population

Prevalence of Nutrition Risk in the Reconstructive Burn Population

Nutritional Screening Of Utah Rural And Urban Elderly

LEARNING OUTCOME: To identify three demographic variables associated with nutrition risk and the overall prevalence of nutrition risk among congregate meal participants in Utah.This study was designed to determine the degree of nutritional risk present within the elderly population in rural and urban areas in the state of Utah by conducting an initial nutrition screening using the Determine Your Nutritional Health checklist developed by the Nutrition Screening Initiative. Congregate meal sites were stratified according to urbanization and fifteen centers were selected from both rural and urban counties. Participants at each site completed a Determine Your Nutritional Health checklist and survey asking demographic data including age, sex, marital status, living situation, frequency of participation in congregate meals, and if they had previously used the checklist.A total of 838 valid surveys was collected from 29 congregate meals sites throughout the state of Utah. Fifty-seven percent of participants scored in the “utritional health”ory, 27.7 percent were at moderate nutrition risk, and 15.4 percent scored in the high nutrition risk category. Checklist statements one, seven, and eight (“I have an illness or condition that made me change the kind and/or amount of food I eat” ; “I eat alone most of the time” ; and “I take 3 or more different prescribed or over-the-counter drugs a day”) had the highest percentages of positive responses at 28.9,33.1, and 39.7 percent, respectively.Nutrition risk category was significantly associated with gender (P=0.04), marital status (P=0.00), and cohabitation status (P=0.00). Women, unmarrieds, and individuals living alone scored more frequently in a higher nutrition risk category.Results of this study reflect influences on nutrition risk found in a sample of congregate meal participants in the state of Utah. These results can help the state of Utah identify the common risk factors within this segment of its population, i.e. gender, marital status, cohabitation status, acute/chronic disease, eating alone, and polypharmacy, to plan education and/or intervention for individuals who are at risk.