Prevalence of malnutrition risk and poor food intake in older adults in Indian hospitals: A prospective observational nutritionDay study with novel mapping of malnutrition risk to the Malnutrition Screening Tool

Nutritional Risk Screening in Hospitalized Adults Using the Malnutrition Universal Screening Tool at a Tertiary Care Hospital in South India

Background and objectives

Malnutrition is still widely prevalent in India. Various nutritional screening tools have been developed to screen for nutritional risk status but no one tool is considered the best. The Malnutrition Universal Screening Tool (MUST) is accepted by the European Society for Clinical Nutrition and Metabolism and validated for use in hospitalized adults. Hence, it was used in this study to estimate the prevalence of malnutrition in hospitalized adults and its association with socioeconomic inequality.

Methods

A sample of randomly selected 358 ambulatory hospitalized patients above 18 years of age was used in the study. Data pertaining to demography, socioeconomic status, medical history, and MUST were collected using a structured questionnaire. The height and weight of the patients were measured, and their BMI was determined. The patients were classified into five socioeconomic classes and their MUST scores were determined.

Results

Statistically significant (P < 0.05) increasing trend was observed in the height, weight, and BMI of patients with increasing socioeconomic status. Diabetes mellitus (39%) followed by hypertension (30%) were the predominant comorbid conditions. According to MUST, the overall prevalence of medium and high risk of malnutrition was 11% and 24%, respectively, and the socioeconomic class that was most impacted was Class 4 (1,130-2,259 INR per capita monthly income).

Interpretation and conclusions

Socioeconomic status influences the prevalence of malnutrition, comorbid conditions, and the anthropometric measurements of admitted patients. The prevalence of nutritional risk status irrespective of sex was found to be 34.91% (24.3% in males and 10.61% in women) in the study.

Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results

BACKGROUND & AIMS

Across the globe, the prevalence of hospital malnutrition varies greatly depending on the population served and on local socioeconomic conditions. While malnutrition is widely recognized to worsen patient outcomes and add financial burdens to healthcare systems, recent data on hospital malnutrition in Latin America are limited. Our study objectives were: (1) to quantify the prevalence of malnutrition risk in Latin American hospital wards, and (2) to explore associations between nutritional risk status, in-hospital food intake, and health outcomes.

METHODS

On nutritionDay (nDay), a specific day every year, hospital wards worldwide can participate in a one-day, cross-sectional audit. We analyzed nDay data collected in ten Latin American countries from 2009 to 2015, including demographic and nutrition-related findings for adult patients (≥18 years) from 582 hospital wards/units. Based on patient-reported responses to questions related to the Malnutrition Screening Tool, we determined the prevalence of malnutrition risk (MST score ≥2). We also summarized patient-reported food intake on nDay, and we analyzed staff-collected outcome data at 30 days post-nDay.

RESULTS

The prevalence of malnutrition risk in the Latin American nDay study population (N = 14,515) was 39.6%. More than 50% of studied patients ate one-half or less of their hospital meal, ate less than normal in the week before nDay, or experienced weight loss in the prior three months. The hospital-mortality hazard ratio was 3.63 (95% CI [2.71, 4.88]; P < 0.001) for patients eating one-quarter of their meal (compared with those who ate the full meal), increasing to 6.6 (95% CI [5.02, 8.7]; P < 0.0001) for patients who ate none of the food offered.

CONCLUSIONS

Based on compilation of nDay surveys throughout Latin America, 2 of every 5 hospitalized patients were at risk for malnutrition. The associated risk for hospital mortality was up to 6-fold higher among patients who ate little or none of their meal on nDay. This high prevalence showed scant improvement over rates two decades ago-a compelling rationale for new focus on nutrition education and training of professionals in acute care settings.