American Journal of Clinical Nutrition, Vol 66, 1232-1239, Copyright © 1997 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Prevalence of malnutrition in nonsurgical hospitalized patients and its association with disease complications

TH Naber, T Schermer, A de Bree, K Nusteling, L Eggink, JW Kruimel, J Bakkeren, H van Heereveld and MB Katan
Department of Gastrointestinal and Liver Diseases, University Hospital Nijmegen, Netherlands. t.naber@gatro@azn.nl

The prevalence of malnutrition and its predictive value for the incidence of complications were determined in 155 patients hospitalized for internal or gastrointestinal diseases. At admission, 45% of the patients were malnourished according to the Subjective Global Assessment (physical examination plus questionnaire), 57% according to the Nutritional Risk Index [(1.5 x albumin) + (41.7 x present/usual weight)], and 62% according to the Maastricht Index [(20.68 - (0.24 x albumin) - (19.21 x transthyretin (prealbumin) - (1.86 x lymphocytes) - (0 04 x ideal weight)]. Crude odds ratios for the incidence of any complication in malnourished compared with well-nourished patients during hospitalization were 2.7 (95% CI: 1.4, 5.3) for the Subjective Global Assessment, 2.8 (1.5, 5.5) for the Nutritional Risk Index, and 3.1 (1.5, 6.4) for the Maastricht Index. Odds ratios were reduced to 1.7 (0.8, 3.6), 1.6 (0.7, 3.3), and 2.4 (1.1, 5.4), respectively, after a multivariate analysis that included disease category and disease severity. Because the confounding factors adjusted for are not only a measure of the severity of the disease but may also be influenced by malnutrition itself, the actual risk for complications due to malnutrition could be higher than the adjusted odds ratios. In conclusion, malnutrition was frequent in patients with gastrointestinal disease and other internal diseases at the time of admission. The severity of malnutrition in the patients predicted the occurrence of complications during their hospital stay and this association was not completely explained by confounding factors.

This article has been cited by other articles:

				J. N. Keith Bedside Nutrition Assessment Past, Present, and Future: A Review of the Subjective Global Assessment Nutr Clin Pract, August 1, 2008; 23(4): 410 - 416. [Abstract] [Full Text] [PDF]

				D. J Secker and K. N Jeejeebhoy Subjective Global Nutritional Assessment for children Am. J. Clinical Nutrition, April 1, 2007; 85(4): 1083 - 1089. [Abstract] [Full Text] [PDF]

				S. Hosseini, B. Amirkalali, N. Nayebi, R. Heshmat, and B. Larijani Nutrition Status of Patients During Hospitalization, Tehran, Iran Nutr Clin Pract, October 1, 2006; 21(5): 518 - 521. [Abstract] [Full Text] [PDF]

				M. G. Beghetto, J. Victorino, L. Teixeira, and M. J. de Azevedo Parenteral Nutrition as a Risk Factor for Central Venous Catheter-Related Infection JPEN J Parenter Enteral Nutr, September 1, 2005; 29(5): 367 - 373. [Abstract] [Full Text] [PDF]

				M. L. Chandler and D. A. Gunn-Moore Nutritional Status of Canine and Feline Patients Admitted to a Referral Veterinary Internal Medicine Service J. Nutr., August 1, 2004; 134(8): 2050S - 2052S. [Full Text] [PDF]

				H. Sungurtekin, U. Sungurtekin, C. Balci, M. Zencir, and E. Erdem The Influence of Nutritional Status on Complications after Major Intraabdominal Surgery J. Am. Coll. Nutr., June 1, 2004; 23(3): 227 - 232. [Abstract] [Full Text] [PDF]

				T. H. Naber Lean body mass depletion is associated with an increased length of hospital stay Am. J. Clinical Nutrition, April 1, 2004; 79(4): 527 - 528. [Full Text] [PDF]

				C. Pichard, U. G Kyle, A. Morabia, A. Perrier, B. Vermeulen, and P. Unger Nutritional assessment: lean body mass depletion at hospital admission is associated with an increased length of stay Am. J. Clinical Nutrition, April 1, 2004; 79(4): 613 - 618. [Abstract] [Full Text] [PDF]

				J. J van Binsbergen and A. J. Drenthen Patient information letters on nutrition: development and implementation Am. J. Clinical Nutrition, April 1, 2003; 77(4): 1035S - 1038. [Abstract] [Full Text] [PDF]

				C. L Braunschweig, P. Levy, P. M Sheean, and X. Wang Enteral compared with parenteral nutrition: a meta-analysis Am. J. Clinical Nutrition, October 1, 2001; 74(4): 534 - 542. [Abstract] [Full Text] [PDF]

				K. N Jeejeebhoy Total parenteral nutrition: potion or poison? Am. J. Clinical Nutrition, August 1, 2001; 74(2): 160 - 163. [Abstract] [Full Text] [PDF]

				Y.-C. Huang, S.-L. Wueng, C.-C. Ou, C.-H. Cheng, and K.-H. Su Nutritional Status of Functionally Dependent and Nonfunctionally Dependent Elderly in Taiwan J. Am. Coll. Nutr., April 1, 2001; 20(2): 135 - 142. [Abstract] [Full Text] [PDF]

				M.-C. Farges, M.-P. Bérard, F. Raul, J.-P. Cézard, B. Joly, P. Davot, M.-P. Vasson, and L. Cynober Oral Administration of a Glutamine-Enriched Diet Before or After Endotoxin Challenge in Aged Rats Has Limited Effects J. Nutr., October 1, 1999; 129(10): 1799 - 1806. [Abstract] [Full Text]