Impact of nutritional status on length of hospital stay

Abstract

surgical unit between 24 th May 2016 and the 22 nd June 2016 were eligible for inclusion in this study. All patients were assessed by a member of the study team within 48 hours of the patients being admitted. A prospective review of the patient's medical and nursing records was undertaken to obtain the data outcomes required. Results: 500 patients (female 236:264 male; mean age 59 years (range 17-100years)) were recruited during the study period. In total 450 patients were from general surgery and 50 patients were from general medicine. Age, cancer diagnosis, emergency admission and female gender were all factors positively linked to increasing incidence of malnutrition. Three hundred and six patients (61%) had presenting symptoms which deleteriously impacted on nutritional status. These included nausea and vomiting (n¼138; 27.6%), diarrhoea or constipation (n¼23; 4.6%), pain (n¼92; 18.4%). Poor appetite and anorexia was reported in 175 patients (34%). Poor tissue viability was reported in 21 patients (4.2%). 130 patients (25%) were nil by mouth at the time of initial assessment by the study team in view of pending surgery. Patients who had a planned admission to hospital had a lower risk of undernutrition using the MUST screening tool when compared to patients admitted as an emergency admission, 25 patients (14.3%) versus 74 patients (22.8%). Our locally used validated nutritional risk screening tool reported 77 planned admission patients (44%) versus 158 emergency patients (48%) were either malnourished or at high risk for malnutrition. Conclusion: Many factors contribute to altered nutritional status. This reinforces the need for robust nutritional screening on admission to hospital and subsequent timely nutritional assessment by trained professionals followed by remedial nutritional treatment. Reference [1] BAPEN.org.uk.

High turnover in clinical dietetics: A qualitative analysis

“…63,64 Following analysis of prospective cohort data collected in Canadian hospitals, Curtis et al (2017) concluded that patients assessed as being severely malnourished (11%) had 53% longer lengths of stay and medical costs 55% higher than those of wellnourished patients. 62 Similar ndings have been reported for malnourished hospitalized patients in Australia (26), the United Kingdom, 65 Singapore 66 and the US 67 More speci c to RD intervention, results of a study by Keller et al (2015) indicate that malnourished patients seen by an RD early in their hospital stay have decreased rates of infection, improved healing and reduced lengths of stay. 18…”

Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs

“…The second most important barrier was "Waiting for the dietitian to assess the patients" [3.22 ±1.2, 3 (2-4)] which was included in the "dietitian support" domain. The mean score of this item as indicated by the dietitians was [3.5 ±1.4, 4 (2-5)], by physicians was [3.2 ±1.1, 3 (2-4)] and by nurses was [2.79 ±1.1, 3 (2)(3)]. The least important barriers were "Non-ICU physicians requesting patients not be fed enterally" [3.01 ±1.2, 3 (2-4)] preceded by "General belief among ICU team that provision of adequate nutrition does not impact on patient outcome" [3.03 ±1.3, 3 (2-4)]; both barriers were included in the "critical care providers attitude and behaviour" domain.…”

“…Nutrition therapy is a vital element of the care process of critically ill adult and paediatric patients. The prognostic impact of nutrition therapy in the critically ill population has previously been documented in the literature; [1][2][3][4][5] however, achieving optimal nutrition remains a challenge in this population. Although nutrition support either enterally or parenterally has substantially improved the patient's nutritional intake, underfeeding continues to be documented in intensive care settings worldwide.…”