Is the skeleton still in the hospital closet? A review of hospital malnutrition emphasizing health economic aspects

Souza, Telma Theodoro de; Sturion, Claudio J.; Faintuch, Joel

doi:10.1016/j.clnu.2015.02.008

Cited by 44 publications

(29 citation statements)

References 38 publications

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“…Malnutrition is a common condition in elderly residents in long-term care (85%), as well as in hospitalized (23-62%) and community dwelling elderly (15%) [10]. The growing awareness of the prevalence of undernutrition in older people and recognition of the adverse effects of major muscle loss during ageing has led to an increase in the use of oral highprotein supplements to increase the intake of protein and energy in the elderly population and, thereby, attenuate the loss of body weight and muscle mass [11]. The rationale for the use of these supplements is strengthened by the observation that, in healthy older people, protein administered both orally [12] and directly into the small intestine [13] suppresses subsequent energy intake less than in young adults.…”

Section: Introductionmentioning

confidence: 98%

The ageing gastrointestinal tract

Soenen

Rayner

Jones

et al. 2016

Current Opinion in Clinical Nutrition and Metabolic Care

185

113

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Alterations in gut function with ageing have particular implications for oesophageal, gastric, and colonic motility. Older individuals are particularly susceptible to malnutrition, postprandial hypotension, dysphagia, constipation, and faecal incontinence. Decrease in the number of nerve cells of the myenteric plexus that impact digestive absorption and the surface area of the small intestine because of degeneration of villi may lead to blunted absorption of nutrients. Impairment of the intestinal immune system as a result of ageing, including the mucosal layer of the gastrointestinal tract, appears to be a significant contributor to the age-related increase in the incidence and severity of infections.

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Section: Introductionmentioning

confidence: 98%

The ageing gastrointestinal tract

Soenen

Rayner

Jones

et al. 2016

Current Opinion in Clinical Nutrition and Metabolic Care

185

113

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“…De fato, a desnutrição hospitalar tem sido relacionada com alta incidência de complicações, mortalidade, readmissões hospitalares, internações mais longas e aumento dos custos para o sistema de saúde (24) . Em uma recente revisão sobre a desnutrição hospitalar (25) , foi observado que a internação de pacientes desnutridos implica em custos de 30 a 70% mais elevados. Um estudo de caso controle com 818 pacientes verificou os efeitos da desnutrição após três anos de sobrevida e acompanhamento, concluindo que os pacientes bem nutridos no início do acompanhamento tiveram uma sobrevida significativamente maior do que aqueles considerados desnutridos.…”

Section: Casuística E Métodosunclassified

Relevância Do Nutricionista Na Diminuição De Reinternações Hospitalares

Zanin¹,

Lima²,

Lima³

et al. 2017

ACS

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Introdução: O comprometimento do estado nutricional de pacientes internados tem relação direta com reinternações e óbito. A intervenção nutricional, conduzida pelo nutricionista, pode diminuir potencialmente as reinternações. Objetivo: Justificar a importância do Nutricionista na Equipe Multidisciplinar e sua contribuição na redução de reinternações em pacientes internados nas enfermarias de Geriatria, Neurologia e Neurocirurgia. Casuística e Métodos: Estudo descritivo observacional, realizado com 99 pacientes reinternados no Hospital de Base de São José do Rio Preto/SP, Brasil. A caracterização, situação nutricional e valor de internação pago pelo SUS foram obtidos por questionário, prontuário eletrônico e Conta da Autorização de Internação Hospitalar. Resultados: Os pacientes em risco nutricional ou desnutridos ficaram mais tempo internados. Oitenta (80,8%) pacientes internados não foram submetidos à avaliação nutricional em todas reinternações. O valor de internação pago pelo SUS nos pacientes com excesso de peso foi maior, e aqueles com risco nutricional ou desnutrição permaneceram mais tempo internados. Conclusão: O nutricionista na equipe multidisciplinar, em todos os níveis de atenção à saúde, contribui na recuperação do estado nutricional, na prevenção das doenças crônicas, na diminuição das reinternações e do tempo de internação.

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“…For decades, the relationship between disease-related malnutrition (DRM) has attracted attention due to significant alterations in weight loss been already observed in patients who had more complications or even died after a poor evolution (Constans et al, 1992;GallagherAllred, Voss, Finn, & McCamish, 1996;Reilly, Hull, Albert, Waller, & Bringardener, 1988;Souza, Sturion, & Faintuch, 2015). The American Society for Parenteral and Enteral Nutrition (White et al, 2012) and the European Society for Clinical Nutrition and Metabolism (Cederholm et al, 2015) reached a consensus on the best way to define the etiopathology of DRM.…”

Section: Introductionmentioning

confidence: 99%

Clinical and financial implications of hospital malnutrition in Spain

Yárnoz-Esquíroz

Lacasa

Riestra

et al. 2019

Euro Eating Disorders Rev

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Objective The aim of this review is to analyse the studies about cost and clinical implications that malnutrition causes in the Spanish hospitals. Material and methods The review of the literature was carried out through a bibliographic search in Web of Science following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) criteria and analyse the cost of treatment of malnourished and anorexia nervosa (AN) patients Results Seventeen studies with economic data related to malnutrition were included. The employment of a nutritional screening is the first tool to determinate the prevalence. Malnutrition is related to an incremental cost due to a longer hospital stay, expensive treatment, and higher rate of readmissions. Malnourished patients present more clinical complications, more infections, and higher mortality. No studies were found with economic data of AN in Spain. Conclusions The prevalence of malnutrition is over 20%, with the elderly patients being the most affected. Nutritional screening is not implanted in all Spanish hospitals in spite of its proven cost‐effectiveness. The cost and the clinical implications of malnutrition make this disease a health national problem. The knowledge of the real cost of AN treatment would increase the interest of public institutions on the development of specific Nutritional Screening tools for an early detection of AN.

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Is the skeleton still in the hospital closet? A review of hospital malnutrition emphasizing health economic aspects

Cited by 44 publications

References 38 publications

The ageing gastrointestinal tract

The ageing gastrointestinal tract

Relevância Do Nutricionista Na Diminuição De Reinternações Hospitalares

Clinical and financial implications of hospital malnutrition in Spain

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