Hospital malnutrition is a detrimental prognostic factor regarding hospital mortality, complications, and length of stay. However, the role of hospitalization itself on nutritional status has not been fully elucidated. We report the results of a secondary analysis from the dataset of a recent cross-sectional study at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Data from patients evaluated at admission and discharge were collected and compared. One hundred thirty-nine patients were evaluated. Mean length of stay was 13.6 (± 7.7) days. Patients at risk of malnutrition, according to NRS-2002, were 75 (53.9%), while 63 (45.3%) were malnourished according to ESPEN Criteria. Compared to admission, at discharge, patients reported a significant decrease in Mid-Upper Arm Circumference (MUAC)—from 26.5 cm (± 3.6) to 25.9 cm (± 3.7) (p = 0.016), a reduction in Phase angle (PhA)—from 4.25° (± 1.20) to 4.01° (± 1.15) (p = 0.005), fat-free mass (FFM)—from 47.5 kg (± 9.19) to 44.9 kg (± 9.4) (p = 0.03) and fat-free mass index (FFMI)—from 16.9 kg/m2 (± 2.3) to 15.8 kg/m2 (± 2.7) (p = 0.04). Laboratory data showed a reduction of albumin—from 29.2 (± 5.7) to 28.0 (± 5.9) (p = 0.01) and Onodera’s PNI- from 29.1 (± 5.6) to 27.6 kg (± 5.6) (p = 0.039). At the multivariate linear regression analysis, the variables significantly associated with a worsening of PhA at discharge are the PhA value at admission and the diagnosis of malnutrition according to ESPEN Criteria. Hospitalization leads to significative changes in nutritional status. A clinical concern should be raised about the quality of hospital food and meal times and on the need for a clinical nutritionist on the ward.

Rinninella, E., Marco, C., Antonino De Lorenzo,, Anselmi, G., Gagliardi, L., Addolorato, G., Miggiano, G. A. D., Gasbarrini, A., Mele, M. C., May nutritional status worsen during hospital stay? A sub-group analysis from a cross-sectional study, <<INTERNAL AND EMERGENCY MEDICINE>>, 2019; 14 (1): 51-57. [doi:10.1007/s11739-018-1944-5] [http://hdl.handle.net/10807/126146]

May nutritional status worsen during hospital stay? A sub-group analysis from a cross-sectional study

Rinninella, Emanuele
Primo
Writing – Original Draft Preparation
;
Marco, Cintoni
Secondo
Data Curation
;
Anselmi, Gaia
Resources
;
Gagliardi, Lucilla
Visualization
;
Addolorato, Giovanni
Supervision
;
Miggiano, Giacinto Abele Donato
Supervision
;
Gasbarrini, Antonio
Penultimo
Supervision
;
Mele, Maria Cristina
Ultimo
Conceptualization
2019

Abstract

Hospital malnutrition is a detrimental prognostic factor regarding hospital mortality, complications, and length of stay. However, the role of hospitalization itself on nutritional status has not been fully elucidated. We report the results of a secondary analysis from the dataset of a recent cross-sectional study at Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Data from patients evaluated at admission and discharge were collected and compared. One hundred thirty-nine patients were evaluated. Mean length of stay was 13.6 (± 7.7) days. Patients at risk of malnutrition, according to NRS-2002, were 75 (53.9%), while 63 (45.3%) were malnourished according to ESPEN Criteria. Compared to admission, at discharge, patients reported a significant decrease in Mid-Upper Arm Circumference (MUAC)—from 26.5 cm (± 3.6) to 25.9 cm (± 3.7) (p = 0.016), a reduction in Phase angle (PhA)—from 4.25° (± 1.20) to 4.01° (± 1.15) (p = 0.005), fat-free mass (FFM)—from 47.5 kg (± 9.19) to 44.9 kg (± 9.4) (p = 0.03) and fat-free mass index (FFMI)—from 16.9 kg/m2 (± 2.3) to 15.8 kg/m2 (± 2.7) (p = 0.04). Laboratory data showed a reduction of albumin—from 29.2 (± 5.7) to 28.0 (± 5.9) (p = 0.01) and Onodera’s PNI- from 29.1 (± 5.6) to 27.6 kg (± 5.6) (p = 0.039). At the multivariate linear regression analysis, the variables significantly associated with a worsening of PhA at discharge are the PhA value at admission and the diagnosis of malnutrition according to ESPEN Criteria. Hospitalization leads to significative changes in nutritional status. A clinical concern should be raised about the quality of hospital food and meal times and on the need for a clinical nutritionist on the ward.
2019
Inglese
Rinninella, E., Marco, C., Antonino De Lorenzo,, Anselmi, G., Gagliardi, L., Addolorato, G., Miggiano, G. A. D., Gasbarrini, A., Mele, M. C., May nutritional status worsen during hospital stay? A sub-group analysis from a cross-sectional study, <<INTERNAL AND EMERGENCY MEDICINE>>, 2019; 14 (1): 51-57. [doi:10.1007/s11739-018-1944-5] [http://hdl.handle.net/10807/126146]
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