Why is iatrogenic malnutrition serious

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Mosby Inc; Krystofiak R, Mueller C. Nutrition screening and assessment. Silver Spring, Md. Joint Commission for Accreditation of Health Care Organizations guidelines: Too late to intervene for nutritionally at-risk surgical patients. Fessler T. Trace element monitoring and therapy for adult patients receiving long-term total parenteral nutrition. Status of nutrition education in medical schools. Nutrition support in the critically ill: A physician survey.

Parrish CR. Enteral feeding: The art and the science. Nutr Clin Pract. Review of the refeeding syndrome. Factors Included in Subjective Global Assessment16 Weight: unintentional loss and time period of loss Dietary intake: normal vs. Publisher of Today's Dietitian. All rights reserved. Home About Contact. The present study provides also the first evidence of applying the novel ESPEN consensus definition of malnutrition in a population of hospitalized geriatric patients.

Only the measurement of FFM may represent some problem. It is so because, in some patients who are not collaborative and may have important physical impairments, it may be quite difficult to gather a reliable data. In addition, it has to be mentioned that BIA is not always available. According to the ESPEN consensus definition, any validated screening tool may be used to identify patients at risk of malnutrition.

Different screening tools will vary in classifying patients according to malnutrition risk. The MUST tool, for example, defines three categories of risk. Considering only the high risk group of patients, we found that MUST tool has an excellent sensitivity and specificity as well as positive and negative predictive values compared to ESPEN definition.

It would be important to clarify, for each screening tool, the categories of patients for which a malnutrition diagnosis should be performed. Some study limitations have to be mentioned. First, this is a retrospective study and, as it is known, retrospective studies have more potential sources of bias and confounding than the prospective ones.

The investigation concentrated on malnutrition at hospital admission. But, it is well known that malnutrition frequently occurs during hospitalization, which may involve patients who are not at risk on admission. Considering that our study was performed in hospitalized patients, hospital-acquired malnutrition should have also been investigated. This investigation was performed with relatively low number of participants; future studies on larger populations should be carried out to confirm our findings.

No information on functional independence of patients were collected in our study but that information should be gathered in order to test how it influences the LOS and hospital mortality.

Considering that the inflammation is also an important etiologic factor for malnutrition, data on inflammatory markers would also be useful and their correlation to LOS and hospital mortality should be tested. The readmission rates and post-discharge mortality 34 as well as the costs and benefits of nutritional interventions should also be evaluated in the future After the approval, patients were invited to participate in the study.

All patients enrolled gave their informed consent for the collection and processing of data for scientific purposes. The corresponding author of this manuscript is PO. All authors have directly participated in data collection during surveys.

MR and NJP carried out statistical analyses. NJP wrote the final version of the manuscript. All authors gave important suggestions for the final version of the content of the article, read its final version and approved it.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Prognostic impact of disease-related malnutrition. Clin Nutr — Derrick J. The Assessment of Nutritional Status of the Community. Google Scholar. Keller HH. Malnutrition in institutionalized elderly: how and why? J Am Geriatr Soc —8.

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Prognostic impact of disease-related malnutrition. Clin Nutr 27 , 5— Malnutrition is prevalent in hospitalized medical patients: are housestaff identifying the malnourished patient? Nutrition 22 , — Download references. You can also search for this author in PubMed Google Scholar. Correspondence to E Cereda. Contributors : All the authors significantly contributed to the work, read and approved the final manuscript.

AD and EC analysed the data. EC and CP wrote the manuscript. All the authors contributed to data interpretation and critical revision of the article. We are particularly grateful to all contributing centres the PIMAI group and the relative personnel nutritional scientists, dieticians and nurses involved in data collection:. Reprints and Permissions. Cereda, E. Eur J Clin Nutr 64, — Download citation. Received : 29 October Revised : 09 March Accepted : 09 March Published : 26 May Issue Date : August Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Advanced search. Skip to main content Thank you for visiting nature. Download PDF. Subjects Health policy Malnutrition Population screening.

Results: In total, subjects were assessed. Conclusion: Present results confirm that in Italy, nutritional care routines are still poor and need improvements. Introduction Nutritional risk is commonly reported at hospital admission Norman et al.

Materials and methods A detailed description of the study design, the protocol, inclusion and exclusion criteria, randomization of the patient for study entry and the assessments performed are provided elsewhere Lucchin et al. Data were collected on: anthropometric measurements: body weight by flat scale or a hoist provided weighting device or a chair scale , height standing or knee height , mid-upper anthropometry arm circumference and triceps skinfold thickness and history of unintentional weight loss.

Table 1 Analytical criteria of malnutrition Lucchin et al. Results In total, subjects were assessed. Table 2 Summary of the gaps in nutritional care routines Full size table. Discussion The primary aim of the PIMAI study was to estimate the dimension of the malnutrition problem in the Italian country and to identify its major determinants to design ad hoc nutritional policies Lucchin et al.

Conclusion Present results from the PIMAI study confirm that in Italy, nutritional routines towards the management of disease-related malnutrition are still poor and need improvements.