Screening for Malnutrition in Older Hospitalised Patients in an Internal Medicine Department of a Greek Public Hospital

Abstract

Background: Malnutrition is a major public health concern that frequently tends to be unrecognized and untreated. About 1/3 of all patients in the hospital are undernourished globally. Malnutrition is significantly more common in older adults, and consequently they are in danger of suffering from malnutrition prior to their admission. Aim:The objectives of the present study were to estimate the prevalence and severity of malnutrition, along with recent weight loss, in older adults admitted to a department of internal medicine in public general hospital in Greece. Methods: Data was collected from a total sample of 127 patients (>65 years old) recruited from the patients admitted to an internal medicine ward by conducting a cross-sectional study. Nutritional status was assessed by using the Mini Nutritional Assessment -Short Form (MNA-SF). Results:The median age of participants was 78 (SD 7.2 years), and among them, 61.4% were women. The prevalence of malnutrition in the hospitalized older patients was 19.7%. According to MNA-SF, 52.7% of older patients were at risk of malnutrition, and among them, 27.6% had decreased food intake during the last three months. During the last three months, 19.7% experienced an unintentional weight loss more than three kg. Additionally, 15% of participants with a Body Mass Index (BMI) over 23 kg/ m2 were classified as malnourished, and only 33% of them were classified with no nutritional problem (p=0.003). Among the 25 malnourished older patients identified by MNA-SF, only 8 were prescribed Oral Nutritional Supplements (O.N.S). Conclusion:The high prevalence of malnourished patients and older patients at risk of malnutrition emphasizes the need for hospitals to adopt a particular policy and a specific set of clinical protocols to identify patients at nutritional risk leading to an appropriate nutritional care plan. Early identification by a validated screening tool, could lead to an effective management of malnutrition.

Evaluation of inappropriate drug use in geriatric patients using the TIME-to-STOP/TIME-to-START criteria in a tertiary hospital

“…Due to their favorable effects, it is recommended that physicians prescribe ONSs to old, malnourished patients [17]. In a study conducted on the elderly in the internal medicine service in Greece, it was observed that ONSs were initiated in 8 out of 25 malnutrition patients, and the rate was higher than in our study [44]. In our study, only 7 of 31 malnutrition patients were administered ONSs, which suggests that dietitians were not consulted and that doctors and nurses need more training about ONSs.…”