Prevalence of malnutrition on admission to four hospitals in England

Edington, John; Boorman, J; Durrant, E R; Perkins, Anthony J.; Giffin, C V; James, Ruth; Thomson, John; Oldroyd, John; Smith, J. C.; Torrance, A.; Blackshaw, V; Green, S; Hill, Cheryl J.; Berry, C; McKenzie, Costner; Vicca, N; Ward, Jason E; Coles, Stephen J.

doi:10.1054/clnu.1999.0121

Cited by 342 publications

(231 citation statements)

References 10 publications

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“…In all, 13 out of 24 (54%) malnourished patients were correctly recognized by the medical staff to be malnourished in the present study. This is in accordance with other studies that report clinical recognition rates of up to 40% (McWhirter & Pennington, 1994;Edington & Kon, 1997;Wilson et al, 1998;Edington et al, 2000).…”

Section: Discussionsupporting

confidence: 93%

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Profile of the malnourished patient

2005

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Objective: To characterize malnutrition in a nonspecific group of newly admitted hospital patients. Design: A prospective, descriptive study aiming to identify typical symptoms of malnutrition in a heterogeneous population of newly admitted patients to the wards of internal medicine. Setting: The wards of internal medicine of the VU University Medical Center. Subjects: A total of 106 patients were included in the study, 70 patients underwent the full interview. Next to nutritional status, the sociodemographics, underlying disease, estimated care complexity, care situation before admission, journey through the care system, nutritional intervention and nutritional follow-up after discharge were described for each patient. Results: Of 70 patients 24 (34%) were malnourished. Malnourished patients suffered two chronic diseases vs one for wellnourished patients (P ¼ 0.05). They also had a higher estimated care complexity (P ¼ 0.035) and a trend towards longer length of hospital stay (P ¼ 0.09). Malnourished patients did not differ from well-nourished patients in age, sex, partner status and care received at home. In all, 54% of the malnourished patients were identified correctly by the medical staff. The reasons for admission to the hospital were diverse in only four out of 24 patients malnutrition was the primary reason for admission. Discharge letters to the general practitioner (GP) contained only fragmentary information about the patients' nutritional status. At 3 months after discharge, most of the GPs were scarcely aware of any nutritional problems of their patients. Conclusions: Malnutrition is difficult to recognize in a nonspecific hospital population. Patients do not present with unique symptoms indicating malnutrition. To be able to correctly identify all malnourished patients, screening of the nutritional status of all newly admitted patients seems to be necessary.

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Section: Discussionsupporting

confidence: 93%

“…Depending on the criteria used, disease related malnutrition is described to occur in 15-50% of these patients (McWhirter & Pennington, 1994;Naber et al, 1997;Corish et al, 2000;Edington et al, 2000;Corish & Kennedy, 2001).…”

Section: Introductionmentioning

confidence: 99%

Profile of the malnourished patient

2005

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“…Malnutrition is still an important problem in hospitals, and its prevalence among hospitalized patients ranges from 10 to 60% (Bruun et al, 1999;Edington et al, 2000;Waitzberg et al, 2001;Cereceda et al, 2003;van Bokhorst-de van der Schueren et al, 2004;Valero et al, 2005) depending on the population, pathology and test used. These rates increase during admission as a result of adverse hospital routines that lead to insufficient intake (Dupertuis et al, 2003) and of the anorexia these patients present .…”

Section: Introductionmentioning

confidence: 99%

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

García²,

et al. 2010

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Background/Objectives: 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. Subjects/Methods: 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 w 2 -test to assess differences between the tests and the k statistic to assess agreement between the tests.

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“…In the UK, 10% of the free-living older population, and 16% of residents in nursing homes are underweight BMI < 20 kg=m 2 (Pullinger, 1999;Finch et al, 1998). About half of hospital admissions are from the older population (Edington et al, 2000). Between 10 and 40% of adult patients admitted to hospital are underweight, and the majority lose more weight during their hospital stay (McWhirter & Pennington, 1994).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of risk of undernutrition is associated with poor health status in older people in the UK

et al. 2003

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Objectives: To establish the prevalence of the risk of undernutrition, using criteria similar to those used by the Malnutrition Advisory Group (MAG), in people aged 65 y and over, and to identify relationships between risk of undernutrition and health and demographic characteristics. Design: A cross-sectional nationally representative sample of free-living and institutionalized older people in the UK (65 y of age and over). Secondary analysis of the National Diet and Nutrition Survey based on 1368 people aged 65 y and over. Results: About 14% (21% in those living in institutions) were at medium or high risk of undernutrition based on a composite measure of low body mass index and recent reported weight loss. Having a long-standing illness was associated with a statistically significantly increased risk of undernutrition (odds ratio: men 2.34, 95% CI 1.20 -4.58; women 2.98; 1.58 -5.62). The risk of undernutrition increased: in women reporting bad or very bad health status; in men living in northern England and Scotland; for those aged 85 y and older; for those hospitalized in the last year, and those living in an institution. Lower consumption of energy, meat products or fruit and vegetables and lower blood measures of zinc, vitamins A, D, E and C were associated with statistically significantly increased risk of undernutrition. Conclusions: A substantial proportion of the older population of the UK is at risk of undernutrition. High-risk subjects are more likely to have poorer health status. It is unlikely that the individuals at high risk are being detected currently, and therefore effective care is not being provided, either in the community or in institutions. Sponsorship: This analysis was partly funded by a grant from the Department of Health. We are grateful for helpful comments from Professor MJ Wiseman and the anonymous reviewers.

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Prevalence of malnutrition on admission to four hospitals in England

Cited by 342 publications

References 10 publications

Profile of the malnourished patient

Profile of the malnourished patient

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

Prevalence of risk of undernutrition is associated with poor health status in older people in the UK

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