14 DAY TRIAL // A new study carried out by Italian researchers concluded that hospital patients admitted with malnutrition or who do not eat for several days, have a greater risk of remaining hospitalized longer than others.
The research involved 1274 adults who were admitted to hospital for medical or surgical interventions, of which 52 patients died in hospital and 149 stayed under three days.
The study population excluded bedridden patients, those who were admitted for same-day procedure or surgery and those admitted for palliative care.
Malnourished patients at the time of admission had a 65% risk of prolonged hospital stay – 7 to 22 days, unlike 4 to 13 days for the others.
Dr. Riccardo Caccialanza, Nutrition and Dietetics Service, Fondazione Policlinico San Matteo, Pavia Italy, and the coauthors say write that “compared with the patients who had a length of stay of at least three days, patients who died in hospital were more likely to have a lower body mass index, to be at nutritional risk, to experience unintentional weight loss both before admission and during their hospital stay, and to have more severe diseases, malignant neoplasms and a greater number of comorbidities.”
The weight loss during hospitalization time is not unusual, because “different factors contribute to [weight-loss during hospital stay], such as the underlying disease, the catabolic stress related to surgical interventions, insufficient oral intake or fasting, as well as the inappropriate management of the nutritional problems of the patients.”
The researchers “observed a strong association between nutritional risk at admission and prolonged length of stay in hospital among ambulatory adult patients.”
“Clinicians should be aware of the potential impact of malnutritional status deterioration in prolonging hospitalization not only in critical bed-ridden patients, but in all hospitalized patients potentially requiring nutritional support.”
Ms. Ursula Kyle and Dr. Jorge Coss-Bu admit that “nutritional risk continues to be unrecognized and undertreated in clinical practice.
“Routine screening of all patients is not always done at hospital admission, and nutritional support is often not started for undernourished patients at high nutritional risk.”
Also, treating patients with nutritional risk is 20% more expensive than the normal cost of treating someone with the same disease but without the nutritional risk.
The study was published in CMAJ (Canadian Medical Association Journal).