The prevalence of malnutrition in spinal cord injuries patients: a UK multicentre study

Abstract

Data on the prevalence of malnutrition among patients with spinal cord injuries (SCI) are lacking. The aim of the present study was to assess nutritional risk at admission, and the status of nutritional support in the UK SCI Centres (SCIC); a cross-sectional, multicentre study in four SCIC. A standardised questionnaire was used and distributed to the participating SCIC. After obtaining informed consent, baseline demographic data, nutritional risk score by the 'Malnutrition Universal Screening Tool', BMI and routine blood biochemistry were collected from every patient admitted to an SCIC. The four SCIC, comprising 48·2 % of the total UK SCI beds, contributed data from 150 patients. On admission, 44·3 % of patients were malnourished or at risk of undernutrition. Nutritional risk was more common in patients with acute high cervical SCI than those with lower SCI (60·7 v. 34·5 %), and nutritional risk was more common in those with additional complications including ventilatory support (with tracheostomy, 56·3 v. 38·7 %). Also, 45 % of patients were at risk of overnutrition (BMI $ 25 kg/m 2 ). The prevalence of malnutrition in SCI patients admitted to SCIC is higher than national figures focused on general hospitalised patients, indicating that SCI patients are particularly vulnerable to malnutrition. Patients with SCI who have a tracheostomy may need additional attention. Given the potential negative impact of malnutrition on clinical outcomes, an emphasis on mandatory nutrition screening, followed by detailed assessment for at-risk individuals should be in place in the SCIC.

Feasibility and Acceptability of Implementing Indirect Calorimetry Into Routine Clinical Care of Patients With Spinal Cord Injury

“…Consuming adequate amounts of nutrition can be challenging for some, particularly in acute injury where malnutrition rates of up to 40% have been reported. 7 In the long term, reduced ability to …”

Relationship between nutritional status and mortality during the first 2 weeks following treatment for cervical spinal cord injury

“…This finding is consistent with previous reports that patients with CSCI are prone to malnutrition and hypoproteinemia in the days and weeks immediately following injury. 16,21 Using mean serum proteins levels to assess nutritional health during this early stage of CSCI, this study demonstrated that patients with CSCI who survived or died were at increased risk for hypoproteinemia and malnutrition during the early period following admission. Hypothetically, it is likely that patients who died in this acute period were more likely to have exhibited negative systemic effects related to poor nutrition and secondary cervical damage, which may be more closely related than previously believed.…”

“…Clinical observations revealed that 44.3% of patients with CSCI were at risk for malnutrition or were already malnourished at the time of admission. 16 Furthermore, patients with CSCI with damage high in the cervical column (C1-4) were more commonly malnourished than other patient groups, and nutritional deficiency was most common in patients requiring ventilatory support. 16 Recent research has indicated that pathological damage below the level of injury in patients with SCI may actually contribute to a number of different complications that affect various organ systems to promote malnutrition, implicated in reduced wound healing and overall poor outcomes.…”

“…16 Furthermore, patients with CSCI with damage high in the cervical column (C1-4) were more commonly malnourished than other patient groups, and nutritional deficiency was most common in patients requiring ventilatory support. 16 Recent research has indicated that pathological damage below the level of injury in patients with SCI may actually contribute to a number of different complications that affect various organ systems to promote malnutrition, implicated in reduced wound healing and overall poor outcomes. 17 Although general therapeutic intervention has become routine in treatment regimens employed in modern rehabilitation settings, the importance of nutritional status intervention as a first-line therapy for patients with CSCI may be undervalued.…”

Meal provision in a UK National Spinal Injury Centre: a qualitative audit of service users and stakeholders

“…1 Despite its importance, malnutrition is rarely identified by clinicians working in general hospitals 2 or in SCI centres (SCIC). 3 We reported previously that the provision of dietetic resources in SCIC is suboptimal, 4 and therefore, it is imperative that hospital catering staff in conjunction with ward-based personnel are proficient in optimising menu design, and in adapting menus, that they have the ability to improve the mealtime atmosphere, and are able to deal with individual patient needs as well as offering a balanced menu that meets patients' nutritional requirements.…”