A visual analogue scale for food intake as a screening test for malnutrition in the primary care setting: Prospective non-interventional study

Bouëtté, G.; Esvan, Maxime; Apel, Katharina; Thibault, Ronan

doi:10.1016/j.clnu.2020.04.042

Cited by 26 publications

(29 citation statements)

References 20 publications

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“…If no data on weight are available, visual inspection of the physical condition of the patient may be enough to diagnose malnutrition in the presence of severe muscle wasting. On the opposite, etiologic criteria are easily identified: (i) Covid-19, as an "acute inflammatory disease"; (ii) food intake within the past week that could be easily assessed with semiquantitative methods: an analog scale between 0 and 10/10) [48] or consumed portions (0, ¼, ½; 1) during lunch or dinner, as collected in the NutritionDay survey [49]; consuming <7/10 should alert to likely malnutrition [48,50]. So, screening should not aim to collect all possible indicators but rely on one of few criteria which are enough to identify patients already malnourished or at high-risk of becoming malnourished who constitute the target for early intervention.…”

Section: Challenge 3: Screening For Malnutrition Should Be Feasiblementioning

confidence: 99%

“…Insufficient food intake is expected to be very frequent in Covid-19 patients: anorexia, dyspnea, post-ICU dysphagia, rapid catabolism and muscular weakness, insufficient human resources to help with the meal and constraints related to isolation. In case food intake would remain insufficient after 48 h (≤50% of consumed food or supplements) [49] or analog scale <7/ 10 [48,50]), we propose that nutrition support should be indicated with EN as first line (Fig. 1).…”

Section: Challenge 6: Adaptation Of Hospital Food Delivery Needs To Bmentioning

confidence: 99%

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How the Covid-19 epidemic is challenging our practice in clinical nutrition—feedback from the field

et al. 2020

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The viral epidemic caused by the new Coronavirus SARS-CoV-2 is responsible for the new Coronavirus disease-2019 (Covid-19). Fifteen percent of the Covid-19 patients will require hospital stay, and 10% of them will need urgent respiratory and hemodynamic support in the intensive care unit (ICU). Covid-19 is an infectious disease characterized by inflammatory syndrome, itself leading to reduced food intake and increased muscle catabolism. Therefore Covid-19 patients are at high risk of being malnourished, making the prevention of malnutrition and the nutritional management key aspects of care. Urgent, brutal and massive arrivals of patients needing urgent respiratory care and artificial ventilation lead to the necessity to reorganize hospital care, wards and staff. In that context, nutritional screening and care may not be considered a priority. Moreover, at the start of the epidemic, due to mask and other protecting material shortage, the risk of healthcare givers contamination have led to not using enteral nutrition, although indicated, because nasogastric tube insertion is an aerosolgenerating procedure. Clinical nutrition practice based on the international guidelines should therefore adapt and the use of degraded procedures could unfortunately be the only way. Based on the experience from the first weeks of the epidemic in France, we emphasize ten challenges for clinical nutrition practice. The objective is to bring objective answers to the most frequently met issues to help the clinical nutrition caregivers to promote nutritional care in the hospitalized Covid-19 patient. We propose a flow chart for optimizing the nutrition management of the Covid-19 patients in the non-ICU wards.

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Section: Challenge 3: Screening For Malnutrition Should Be Feasiblementioning

confidence: 99%

Section: Challenge 6: Adaptation Of Hospital Food Delivery Needs To Bmentioning

confidence: 99%

How the Covid-19 epidemic is challenging our practice in clinical nutrition—feedback from the field

et al. 2020

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“…In a recent publication, Bouëtté and al. found an association between oral intakes < 7/10 and the existence of malnutrition according to GLIM criteria in a population of general medicine practice patients [20]. One rst explanation of our results could be a lack of power for this criterion.…”

Section: Discussionmentioning

confidence: 56%

“…It showed a high prevalence (37.5%) of malnutrition in hospitalized patients with 26% of severe malnutrition. Median albuminemia was very low (24 [18][19][20][21][22][23][24][25][26][27] g/L) and pectoralis muscle area index was not associated with recent malnutrition. There were no association between recent malnutrition and the need for ICU admission.…”

Section: Discussionmentioning

confidence: 93%

Prevalence of malnutrition in COVID-19 inpatients: the Nutricov study

Rouget

Vardon-Bounes

Lorber

et al. 2020

Preprint

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Background: Recent ESPEN guidelines highlighted the interest of prevention, diagnosis and treatment of malnutrition in the management of coronavirus disease 19 (COVID-19) patients. The aim of our study was to evaluate the prevalence of malnutrition in patients hospitalized for COVID-19. Methods: Prospective observational cohort study on COVID-19 inpatients admitted to a tertiary hospital. Malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition two-step approach. Patients were divided in two groups according to the diagnosis of malnutrition. Covariate selection for the multivariate analysis was based on P value <0.2 in univariate analysis, with a logistic regression model and a backward elimination procedure. A partitioning of the population was represented using a Classification and Regression Tree analysis.Results: 80 patients were prospectively enrolled in the study. Thirty patients (37.5%) had criteria for malnutrition. The need for ICU admission (n=46, 57.5%) was similar in the two groups. Three patients who died (3.75%) were malnourished. Multivariate analysis exhibited that low BMI (OR=0.83, 95% CI [0.73-0.96], p=0.0083), dyslipidemia (OR=29.45, 95% CI [3.12-277.73], p=0.0031), oral intakes reduction <50% (OR=3.169, 95% CI [1.04-9.64], p=0.0422) and GFR (CKD-EPI) at admission (OR=0.979, 95% CI [0.96-0.998], p=0.0297) were associated with the occurrence of malnutrition in COVID-19 inpatients.Conclusions: We demonstrate the existence of a high prevalence of malnutrition (37.5%) in a general cohort of COVID-19 inpatients according to GLIM criteria. Considering this high prevalence, nutritional support in COVID-19 care seems an essential element. Trial registration: Ethical Committee No 2020-A01237-32)(RC31/20/0165 NUTRI-COV

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“…Malnutrition can be prevented or contained by prompt nutritional support [6]. Early nutritional supplementation of non-ICU patients hospitalized for COVID-19 has been recommended by the French-speaking Society for Clinical Nutrition and Metabolism [7] as well as European Society for Clinical Nutrition and Metabolism (ESPEN) experts [8].…”

Section: Introductionmentioning

confidence: 99%