Prevalence of hospital malnutrition among cardiac patients: results from six nutrition screening tools

Abstract

Malnutrition is highly prevalent among hospitalized patients, ranging from 30% to 50% depending on the patient population and the criteria used for diagnosis. Identifying early those who are malnourished and at risk of malnutrition and intervening at an early stage will improve patients overall prognosis and will reduce the costs to the state. Even though cardiac patients are at risk of malnutrition, data on the prevalence of malnutrition among cardiology inpatients is limited. The aim of the study was to assess malnutrition status of the newly admitted patients in a specialist cardiology institution in Sri Lanka by internationally recommended nutrition screening and assessment tools. During study period, 322 (61.22%) males and 204 (38.78%) females were recruited. Malnutrition status assessed by each screening tool had a wide variation. According to Mini Nutritional Assessment tool 69.6% were having possible malnutrition. Malnutrition Screening Tool 47.9% to be at risk of malnutrition. Subjective Global Assessments categorized only 4.2% as malnourished on the other hand Malnutrition Universal Screening Tool categorized 20.4% and 19.6% subjects as at medium risk and high risk of malnutrition respectively. Nutritional Risk Screening detected 6.3%, 25.1% and 24.9% patients to be mildly, moderately and severely malnourished respectively. Short Nutrition Assessment Questionnaire categorized 5.0% and 17.7% patients to be moderately malnourished and severely malnourished correspondingly. In conclusion, Although malnutrition was prevalent among this population, a wide variation in the nutritional status when assessed by widely used internationally recognized tools was observed.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-412) contains supplementary material, which is available to authorized users.

Development of a food atlas for Sri Lankan adults

“…However, portion estimation using photographs seems to be the most practical method, as photographs can be made of any required portions of any food, and can be conveniently carried by interviewers [30]. Nevertheless, a previous study has confirmed that presenting aids in the form of photographs, other two-dimensional representations, or three-dimensional models appear to yield similar results [11].…”

“…A study has found that the errors which are frequently occurring when estimating portion sizes using photographs, were generally small (<10%) to moderate (10-25%) [11]. Nelson et al have revealed the flat slope phenomenon and a regression to mean effect; small portion sizes are overestimated, large portion sizes are underestimated and medium portion sizes usually estimated comparatively well [32].…”

“…It has conclusively been shown that under-or overestimations occurred most likely with respect to the certain visual characteristics of the foods or how the food was presented. For example, a given amount of food can be portrayed in the corresponding photograph in pieces which were either smaller and more numerous or larger and less numerous than in reality [11]. For some foods the way it is presented may become a limiting factor when determining their portion (e.g.…”

“…According to recent studies, the corresponding percentages of Sri Lankan adults in the overweight, obese and centrally obese categories were 25.2, 9.2 and 26.2% [7] and the age-adjusted prevalence for metabolic syndrome was 24.3% [8] while 23.7% adults were suffering from hypertension [9], with one in every five adults aged above 20 years having either diabetes or pre-diabetes [10]. On the other hand, a high prevalence of malnutrition among hospitalized patients has been reported recently [11]. In addition, the prevalence of stunting, underweight, wasting and anaemia among children were 7.1, 16.9, 21.2 and 7.4%, respectively [12].The prevalence of under nutrition among the institutionalized elderly living in Sri Lanka was 30% [13].…”

The use of mid upper arm circumference and skinfold thickness to assess underweight and obesity among cardiac patients

“…Data were collected by a trained medical officer. Details of the study have been reported elsewhere (18). Only the patients, giving informed written consent, were included.…”