Costs of hospital malnutrition

Curtis, Lori; Bernier, Paule; Jeejeebhoy, Khursheed N.; Allard, Johane P.; Duerksen, Donald R.; Gramlich, Leah; Laporte, Manon; Keller, Heather

doi:10.1016/j.clnu.2016.09.009

Cited by 204 publications

(177 citation statements)

References 18 publications

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“…The cost for treating a malnourished patient in hospital is approximately $2000 (CAD) more per patient than the cost to treat a well-nourished patient (Curtis et al 2016;Norman et al 2011;Barker et al 2011;Correia and Waitzberg 2003). Canadian research also demonstrates that most patients remain in the nutritional state in which they were admitted or decline further while in hospital; a similar pattern is observed 30 days after discharge, leading to readmission (Allard et al 2016a(Allard et al , 2016b.…”

Section: Health Implications Of Malnutritionmentioning

confidence: 55%

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Laur

McNicholl

Valaitis

et al. 2017

Appl. Physiol. Nutr. Metab.

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125

116

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Abstract:There is increasing awareness of the detrimental health impact of frailty on older adults and of the high prevalence of malnutrition in this segment of the population. Experts in these 2 arenas need to be cognizant of the overlap in constructs, diagnosis, and treatment of frailty and malnutrition. There is a lack of consensus regarding the definition of malnutrition and how it should be assessed. While there is consensus on the definition of frailty, there is no agreement on how it should be measured. Separate assessment tools exist for both malnutrition and frailty; however, there is intersection between concepts and measures. This narrative review highlights some of the intersections within these screening/assessment tools, including weight loss/decreased body mass, functional capacity, and weakness (handgrip strength). The potential for identification of a minimal set of objective measures to identify, or at least consider risk for both conditions, is proposed. Frailty and malnutrition have also been shown to result in similar negative health outcomes and consequently common treatment strategies have been studied, including oral nutritional supplements. While many of the outcomes of treatment relate to both concepts of frailty and malnutrition, research questions are typically focused on the frailty concept, leading to possible gaps or missed opportunities in understanding the effect of complementary interventions on malnutrition. A better understanding of how these conditions overlap may improve treatment strategies for frail, malnourished, older adults.Key words: frailty, malnutrition, screening, assessment, diagnosis, handgrip strength, oral nutritional supplements, older adult.Résumé : Les effets néfastes de la fragilité des personnes âgées sur leur santé ainsi que la forte prévalence de malnutrition dans cette strate de la population suscitent une prise de conscience grandissante. Les experts dans ces deux domaines doivent être au fait du chevauchement des construits, du diagnostic et du traitement de la fragilité et de la malnutrition. Il n'y a pas encore de consensus au sujet de la définition de la malnutrition et de son évaluation. Concernant la fragilité, on s'entend sur sa définition, mais pas sur sa mesure. Il existe pourtant des outils distincts de mesure de la malnutrition et de la fragilité et, d'ailleurs, les concepts et mesures présentent une intersection. Cette revue narrative souligne les intersections entre les outils de dépistage et d'évaluation comme la perte de poids/diminution de la masse corporelle, de la capacité fonctionnelle et la faiblesse (force de préhension manuelle). En guise de tentative, on propose un ensemble minimal de mesures objectives pour la détermination ou, à tout le moins, l'identification d'un risque dans les deux conditions. La fragilité et la malnutrition aboutissent, études à l'appui, à des problèmes de santé similaires justifiant des stratégies communes de traitement tels les suppléments nutritionnels oraux. Alors que plusieurs résultats du traitement c...

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Section: Health Implications Of Malnutritionmentioning

confidence: 55%

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Laur

McNicholl

Valaitis

et al. 2017

Appl. Physiol. Nutr. Metab.

Self Cite

125

116

View full text Add to dashboard Cite

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“…Analysis performed on data from the Canadian Malnutrition Task Force prospective cohort study, combined with administrative data from the Canadian Institute for Health Information (956 patients admitted to medical and surgical wards in 18 hospitals across Canada), demonstrated that undernourished patients had longer hospital stay and, consequently, cost higher than well‐nourished patients with similar characteristics. In addition, severely undernourished patients (11% of surveyed patients) had 34% longer LOS and total costs 38% higher than well‐nourished patients …”

Section: Introductionmentioning

confidence: 99%

Subjective Global Assessment Can Be Performed in Critically Ill Surgical Patients as a Predictor of Poor Clinical Outcomes

et al. 2018

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“…However, it is important to recognize that malnourished patients have upwards of 55% increase in hospitalization costs, and therefore, medical therapy that may prevent their hospitalization may actually be cost effective. Furthermore, the cost of traditional nutrition therapy, such as TPN, ranges from $60 000 to $100 000 per year . In fact, according to the same source, associated costs of the complications of TPN may add in an additional $10 000 to $50 000 per year.…”

Section: What Is New and Conclusionmentioning

confidence: 99%

Off‐label use of aprepitant for scleroderma‐associated nausea and vomiting: A case report

Jubran

Bolduc²,

Eng³

et al. 2019

J Clin Pharm Ther

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What is known and objective Scleroderma is a disease characterized by excessive deposition of collagen and extracellular matrix proteins in affected organ systems, which results in tissue fibrosis and organ dysfunction. It is estimated that 90% of patients with systemic sclerosis have gastrointestinal involvement, with approximately 50% being symptomatic. Clinical manifestations of gastrointestinal scleroderma manifestations relate to impaired motility and absorption and ultimately malnutrition. Treatments for these symptoms often fail and are limited. The objective of this case report is to highlight the potential use of a substance P antagonist in the treatment of scleroderma associated nausea. Case summary A 56‐year‐old woman presented with GI complications of her underlying systemic sclerosis. The majority of her stay was marked by severe nausea and vomiting, resistant to numerous therapies. Obstructive causes for her symptoms were ruled out with a gastroscopy. A motility study revealed completely absent peristalsis in her esophagus, likely due to complete fibrosis of smooth muscle fibres. For the first time, off‐label use of aprepitant 80 mg once daily was trialed with success in hospital. With this medication, she was able to maintain an adequate oral intake and ultimately achieve discharge from hospital. What is new and conclusion Despite the wide array of medications for gastrointestinal scleroderma, their effect is very limited. In this article, we report to the best of our knowledge the first successful use of the substance P antagonist aprepitant to treat refractory nausea and vomiting in a patient with gastrointestinal scleroderma. Not only does this medication carry promise in treating the GI symptoms of scleroderma, but it may also prove cost effective as compared to PEG insertions or TPN. This case study is congruent with recent evidence of the utility of aprepitant in other infiltrative disease conditions. This may spur interest randomized control trials for expanding the role of this medication.

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Costs of hospital malnutrition

Cited by 204 publications

References 18 publications

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Malnutrition or frailty? Overlap and evidence gaps in the diagnosis and treatment of frailty and malnutrition

Subjective Global Assessment Can Be Performed in Critically Ill Surgical Patients as a Predictor of Poor Clinical Outcomes

Off‐label use of aprepitant for scleroderma‐associated nausea and vomiting: A case report

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