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Santosa, Agus, Sri Mulatsih, and Susetyowati Susetyowati. "Identifikasi risiko malnutrisi dan evaluasi status nutrisi pasien kanker anak dengan pengobatan kemoterapi." Jurnal Gizi Klinik Indonesia 15, no. 4 (April 30, 2019): 137. http://dx.doi.org/10.22146/ijcn.37015.
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Identification of malnutritional risk and nutrition status evaluation of pediatric cancer patients with chemotherapy treatmentBackground: Hospitalized childhood cancer patients had a high risk for malnutrition, either caused by the disease or effects of cancer treatment. Malnutrition in cancer patients gives negative impacts on treatment outcomes in the form of increasing morbidity and mortality rates. Nutrition screening for identifying malnutrition risks could prevent malnutrition in hospitals.Objectives: Investigating the influence of malnutrition risk during hospitalization on the changes in the nutritional status of childhood cancer patients with chemotherapy treatment. Methods: This research was observational research with the nested case-control design. The research subjects were childhood cancer patients aged 2-18 years old meeting the inclusion criteria. They were 64 in number consisting of the case group involving 32 patients and a control group involving the rest. During hospitalization, analyses of nutritional intake, change in body weight, nutritional status, and hospitalization period. Furthermore, the analyses of the influence of malnutrition risk on the outcome between those two groups were then compared. Results: There was a significant influence of malnutrition risk on less energy intake (p<0.001), less protein intake (p=0.002), weight loss >2% (p<0.001), poor nutritional status based on the BMI/U (p=0.011), and longer hospitalization (p=0.034). The group of patients with malnutrition risks had risks of 15.5 (CI 95%: 3.991-63.359) times higher for less energy intake, 6.12 (CI 95%: 1.675-24.906) times higher for less protein intake, and 45.3 (CI 95%: 5.666-1940.768) times higher for weight loss > 2% than the group of patients without malnutrition risks.Conclusions: Patients with a significant risk of malnutrition had less energy and protein intake, weight loss > 2%, poor nutritional status based on BMI/U, and longer hospitalization.
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Mosselman, Machteld J., Cas L. J. J. Kruitwagen, Marieke J. Schuurmans, and Thóra B. Hafsteinsdóttir. "Malnutrition and Risk of Malnutrition in Patients With Stroke." Journal of Neuroscience Nursing 45, no. 4 (August 2013): 194–204. http://dx.doi.org/10.1097/jnn.0b013e31829863cb.
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Lochs, Herbert, and Christos Dervenis. "Malnutrition – The Ignored Risk Factor." Digestive Diseases 21, no. 3 (2003): 196–97. http://dx.doi.org/10.1159/000074105.
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White, Jane V., Nancy Stotts, Sandra W. Jones, and Evelyn Granieri. "Managing Postacute Malnutrition (Undernutrition) Risk." Journal of Parenteral and Enteral Nutrition 37, no. 6 (August 22, 2013): 816–23. http://dx.doi.org/10.1177/0148607113492339.
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Magdalena, M., M. Bielska, T. Czernicki, A. Marchel, and D. Szostak-Węgierek. "MON-LB261: Malnutrition and Risk of Malnutrition in Neurosurgical Patients." Clinical Nutrition 35 (September 2016): S249. http://dx.doi.org/10.1016/s0261-5614(16)30895-0.
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Marinho, R. C., M. S. Lopes, A. Pessoa, J. Rosinhas, J. Pinho, J. Silveira, A. Amado, et al. "Agreement between malnutrition risk subjectively evaluated by physicians and malnutrition (risk) by validated instruments." Clinical Nutrition 37 (September 2018): S239. http://dx.doi.org/10.1016/j.clnu.2018.06.1849.
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Einav, Larisa, Ayal Hirsch, Yulia Ron, Nathaniel Aviv Cohen, Sigalit Lahav, Jasmine Kornblum, Ronit Anbar, Nitsan Maharshak, and Naomi Fliss-Isakov. "Risk Factors for Malnutrition among IBD Patients." Nutrients 13, no. 11 (November 16, 2021): 4098. http://dx.doi.org/10.3390/nu13114098.
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(1) Background: Malnutrition is a highly prevalent complication in patients with inflammatory bowel diseases (IBD). It is strongly associated with poor clinical outcomes and quality of life. Screening for malnutrition risk is recommended routinely; however, current malnutrition screening tools do not incorporate IBD specific characteristics and may be less adequate for screening these patients. Therefore, we aimed to identify IBD-related risk factors for development of malnutrition. (2) Methods: A retrospective case-control study among IBD patients attending the IBD clinic of the Tel-Aviv Medical Center for ≥2 consecutive physician consultations per year during 2017–2020. Cases who had normal nutritional status and developed malnutrition between visits were compared to matched controls who maintained normal nutritional status. Detailed information was gathered from medical files, including: demographics, disease phenotype, characteristics and activity, diet altering symptoms and comorbidities, medical and surgical history, annual healthcare utility, nutritional intake and the Malnutrition Universal Screening Tool (MUST) score. Univariate and multivariate analyses were used to identify malnutrition risk factors. The independent risk factors identified were summed up to calculate the IBD malnutrition risk score (IBD-MR). (3) Results: Data of 1596 IBD patients met the initial criteria for the study. Of these, 59 patients developed malnutrition and were defined as cases (n = 59) and matched to controls (n = 59). The interval between the physician consultations was 6.2 ± 3.0 months, during which cases lost 5.3 ± 2.3 kg of body weight and controls gained 0.2 ± 2.3 kg (p < 0.001). Cases and controls did not differ in demographics, disease duration, disease phenotype or medical history. Independent IBD-related malnutrition risk factors were: 18.5 ≤ BMI ≤ 22 kg/m2 (OR = 4.71, 95%CI 1.13–19.54), high annual healthcare utility (OR = 5.67, 95%CI 1.02–31.30) and endoscopic disease activity (OR = 5.49, 95%CI 1.28–23.56). The IBD-MR was positively associated with malnutrition development independently of the MUST score (OR = 7.39, 95%CI 2.60–20.94). Among patients with low MUST scores determined during the index visit, identification of ≥2 IBD-MR factors was strongly associated with malnutrition development (OR = 8.65, 95%CI 2.21–33.82, p = 0.002). (4) Conclusions: We identified IBD-related risk factors for malnutrition, highlighting the need for a disease-specific malnutrition screening tool, which may increase malnutrition risk detection.
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Duggal, Priya, and William A. Petri. "Does Malnutrition Have a Genetic Component?" Annual Review of Genomics and Human Genetics 19, no. 1 (August 31, 2018): 247–62. http://dx.doi.org/10.1146/annurev-genom-083117-021340.
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Malnutrition is a complex disorder, defined by an imbalance, excess, or deficiency of nutrient intake. The visible signs of malnutrition are stunted growth and wasting, but malnourished children are also more likely to have delays in neurocognitive development, vaccine failure, and susceptibility to infection. Despite malnutrition being a major global health problem, we do not yet understand the pathogenesis of this complex disorder. Although lack of food is a major contributor to childhood malnutrition, it is not the sole cause. The mother's prenatal nutritional status, enteric infections, and intestinal inflammation also contribute to the risk of childhood malnutrition and recovery. Here, we discuss another potential risk factor, host and maternal genetics, that may play a role in the risk of malnutrition via several biological pathways. Understanding the genetic risks of malnutrition may help to identify ideal targets for intervention and treatment of malnutrition.
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Gusdal, Annelie K., Rose-Marie Johansson-Pajala, Marina Arkkukangas, Anna Ekholm, and Viktoria Zander. "Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden: A Registry Study." SAGE Open Nursing 7 (January 2021): 237796082110261. http://dx.doi.org/10.1177/23779608211026161.
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Introduction Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.
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Kollár, Dániel, Zoltán Benedek-Tóth, András Drozgyik, F. Tamás Molnár, and Attila Oláh. "A perioperatív tápláltsági állapot mint kockázati tényező az onkológiai sebészetben." Orvosi Hetilap 162, no. 13 (March 28, 2021): 504–13. http://dx.doi.org/10.1556/650.2021.31987.
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Összefoglaló. Bevezetés: A tumorsebészetben a malnutritio független rizikófaktor. A kockázatcsökkentés egyik fontos eleme a perioperatív tápláltsági állapot felmérésén alapuló klinikai táplálás. Az irodalomban jól dokumentált az időben végzett rizikószűrés fontossága, de ennek módja, különösen hazai környezetben, kidolgozatlanabb. Célkitűzés: A malnutritio szempontjából esendőbb csoportot alkotó onkológiai sebészeti betegek azonosíthatóságának igazolása, a szűrési metódus vizsgálata. Módszer: 2016. október és 2018. november között öt kórcsoportban (emlő, máj, pancreas, mellkas, gyomor-bél rendszer) az igazolt vagy gyanított malignitás, illetve gyulladásos bélbetegség miatt műtétre váró betegeket telemedicina-módszerrel kerestük fel. A rizikócsoportokat (nincs rizikó – alultápláltság valószínűsíthető – súlyos alultápláltság) a sebész és dietetikus által közösen vezetett ’Nutritional Risk Score 2002’ (NRS 2002) szűrő pontrendszerrel állapítottuk meg. Az NRS 2002 pontértékeket a posztoperatív lefolyással vetettük össze (kórházi tartózkodás, 30 napon belüli szövődmények Clavien–Dindo szerinti osztályozása). Prospektív vizsgálatunkban 1556 beteg szerepel. Eredmények: Az emlősebészeti betegek (n = 314) 95,2%-a rizikómentes. A májreszekcióra várók (n = 79) 43%-a valószínűleg vagy biztosan alultáplált. A hasnyálmirigyműtétre előjegyzett betegek (n = 122) 81,2%-a emelt rizikójú. A kuratív célú pancreasreszekción átesett betegek pontértéke alacsonyabb, mint a palliatív műtétben részesülőké (p>0,05). A tüdőreszekcióra váró (n = 219) betegeknél 40,7% került emelt rizikócsoportba. Az emelkedett NRS 2002 érték magasabb szövődményaránnyal járt (p<0,05). Béltraktust érintő műtétek (n = 822) esetén a betegek 71,2%-a valószínűleg vagy biztosan súlyosan alultáplált. Az előrehaladott tumorok és a szövődmények egyaránt erős összefüggést mutattak az NRS 2002 értékkel (p<0,01). Következtetés: Az NRS 2002 szűrőmódszer prediktív értékkel bír mind a tumorstádium, mind a szövődmények tekintetében. Módszerünkkel időben felismerhető a fokozott rizikót jelentő betegcsoport, így a pontérték alapján célzott mesterséges táplálás tervezhető. Orv Hetil. 2021; 162(13): 504–513. Summary. Introduction: Malnutrition is an independent risk factor in oncologic surgery. Perioperative screening and aimed clinical nutrition are key elements in risk reduction. The importance of timely screening has been well published, but its method is underdeveloped, especially in Hungary. Objective: Evaluation of a malnutrition screening method to identify patients at risk in oncologic surgery. Method: Patients were enrolled from October 2016 to November 2018 in five groups (breast, liver, pancreas, thoracic and gastrointestinal surgery). All patients awaiting surgery for suspected or proven malignancy or for inflammatory bowel disease were screened preoperatively via telephone (telemedicine). Probability for malnutrition (no risk – suspicion for malnutrition – severe malnutrition) was jointly assessed by surgeon and dietitian using Nutritional Risk Score 2002 (NRS 2002). Screening results were compared to the postoperative course (including length of stay and 30-day morbidity/mortality using Clavien–Dindo classification). A total of 1556 patients were identified prospectively. Results: 95.2% of breast surgery patients (n = 314) were not at risk. Malnutrition was suspected or detected in 43% of patients awaiting liver resection (n = 79). Increased risk is present in 81.2% of pancreatic surgery cases (n = 122). Pancreas resections with curative intent were associated with lower scores than in palliative operations (p>0.05). 40.7% of the 219 patients scheduled for lung resection had increased malnutrition risk. Higher NRS 2002 resulted in increased morbidity rate (p<0.05). Surgery on the intestines was performed on 822 cases. 71.2% of them had suspected or severe malnutrition. Presence of advanced cancer and complication rate showed strong relations with increased NRS 2002 (p<0.01). Conclusion: Screening with NRS 2002 has predictive value on both tumor stage and complications. Our method is sound to identify patients at malnutrition risk in time, and thus an aimed clinical nutrition therapy can be planned. Orv Hetil. 2021; 162(13): 504–513.
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Bocock, Mary Ann, Heather H. Keller, and Paula M. Brauer. "Defining Malnutrition Risk For Older Home Care Clients." Canadian Journal of Dietetic Practice and Research 69, no. 4 (December 2008): 171–76. http://dx.doi.org/10.3148/69.4.2008.171.
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Purpose: The Resident Assessment Instrument–Home Care (RAI-HC) is widely used to assess needs of home care clients and includes five items used to screen for malnutrition. This study involved defining malnutrition risk and identifying other items within the RAI-HC that might improve malnutrition screening among adults aged 65 or older receiving home care. Methods: A literature review, three focus groups of community care access centre case managers (n=29), and five key informant interviews with registered dietitians were used to identify malnutrition risk factors and indicators. A nominal group (n=5) was used to rank RAI-HC malnutrition risk items. Data were charted and integrated to create the final list of potential risk factors. Results: Seven malnutrition indicators (dietary intake, appetite, dysphagia, nutrition support, end-stage disease, weight status, and fluid intake) and seven risk factors (health status, functional ability, self-reported poor health, mood status, social function, cognitive performance, and trade-offs) were considered important concepts in the construct of malnutrition for older home care clients. Conclusions: These items identified through divergent methods form the basis for developing a screening-formalnutrition-risk tool for home care.
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Pirlich, Matthias, Tatjana Schütz, Martin Kemps, Niklas Luhman, Natalie Minko, Heinrich Josef Lübke, Karin Rossnagel, Stefan N. Willich, and Herbert Lochs. "Social risk factors for hospital malnutrition." Nutrition 21, no. 3 (March 2005): 295–300. http://dx.doi.org/10.1016/j.nut.2004.06.023.
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Karl, Alexander, Peter Rittler, Alexander Buchner, Vincent Fradet, Sebastian Walther, and Christian G. Stief. "RISK OF MALNUTRITION IN UROLOGICAL PATIENTS." Journal of Urology 181, no. 4S (April 2009): 8. http://dx.doi.org/10.1016/s0022-5347(09)60033-1.
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Hogan, Michelle. "Malnutrition-Inflammation Modifies Cardiovascular Risk Relationships." Nephrology Times 3, no. 10 (October 2010): 6–7. http://dx.doi.org/10.1097/01.nep.0000390697.15085.04.
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Bakkaloglu, O. K., and B. Saka. "Malnutrition risk assesment of adult inpatients." Clinical Nutrition 37 (September 2018): S236. http://dx.doi.org/10.1016/j.clnu.2018.06.1839.
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Raman, Leela. "Maternal risk factors in intrauterine malnutrition." Indian Journal of Pediatrics 54, no. 4 (July 1987): 503–10. http://dx.doi.org/10.1007/bf02749043.
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Arora, N. K. "Maternal risk factors in intrauterine malnutrition." Indian Journal of Pediatrics 55, no. 2 (March 1988): 339–40. http://dx.doi.org/10.1007/bf02722217.
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Figueiroa, S., M. Steffy, A. Dourney, A. Barber, P. Delmerico, E. Kelsey, H. Park, M. Taylor, and K. Wallace. "Sepsis, Malnutrition, and Hospital Readmission Risk." Journal of the Academy of Nutrition and Dietetics 121, no. 9 (September 2021): A31. http://dx.doi.org/10.1016/j.jand.2021.06.086.
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Stratton, Rebecca J., and Marinos Elia. "Deprivation linked to malnutrition risk and mortality in hospital." British Journal of Nutrition 96, no. 5 (November 2006): 870–76. http://dx.doi.org/10.1017/bjn20061852.
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This study aimed to investigate the link between deprivation and in-hospital malnutrition and to assess any independent and interrelated effects of deprivation and malnutrition on clinical outcome in hospital. One thousand patients (mean age 71 (sd 19) years, mean BMI 25·6 (sd 5·4) kg/m2) were screened for malnutrition (using the Malnutrition Universal Screening Tool (‘MUST’)) and their clinical outcome assessed prospectively. The deprivation of patients' locality of residence prior to admission was recorded using the Index of Multiple Deprivation 2000 (IMD). Patients with medium and high malnutrition risk (42 %, n 420) were admitted from areas with significantly greater deprivation (lower ranks) than low-risk patients (IMD 3731 v. 3946; P<0·02). The prevalence of malnutrition increased by multiples of 1·14 (95 % CI 1·02, 1·28) for each increment in quartile of IMD rank. The odds of malnutrition of the most deprived quartile were greater than those of the least deprived quartile by a factor of 1·59 (95 % CI 1·11, 2·28). They were also greater for five of the six components of IMD deprivation (and by a factor of 1·73 (95 % CI 1·20, 2·49) for income and 1·69 (95 % CI 1·18, 2·42) for employment). Greater in-hospital mortality was associated with malnutrition, independently of IMD (or its individual components; odds ratio 2·04 (95 % CI 1·22, 3·44)). Length of stay was associated only with malnutrition risk (P<0·0005). This study highlights that in-hospital malnutrition and deprivation are interrelated, yet have independent, adverse associations with patient outcome. Effective strategies are required to tackle these common health inequalities in both clinical and public health settings.
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Korwel, K. M., H. Hjortswang, M. Eberhardson, and K. Pihl Lesnovska. "P023 Prevalence of malnutrition, risk of malnutrition and quality of life among patients with Inflammatory Bowel Disease." Journal of Crohn's and Colitis 16, Supplement_1 (January 1, 2022): i147—i148. http://dx.doi.org/10.1093/ecco-jcc/jjab232.152.
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Abstract Background The relapsing and remitting course of inflammatory bowel disease (IBD) with inflammation and gut symptoms may result in an elevated risk of malnutrition and impaired quality of life. Patients with pro-longed active IBD are at the highest risk of developing impaired nutritional status. The aim of this study was to determine the prevalence of malnutrition and risk of malnutrition in outpatients with inflammatory bowel disease. Furthermore, to study their body composition, identify factors associated with malnutrition and investigate the association between malnutrition and quality of life. Methods A total of 328 IBD outpatients, (154 [47 %] with Crohn’s disease (CD) and 174 [53%] with ulcerative colitis (UC)) at Linköping University hospital were included in this population-based cross-sectional study. Patients underwent malnutrition assessment using the recently published Global Leadership Initiative on Malnutrition (GLIM) criteria. Data about body mass index, weight loss and dietary problems were collected and used to evaluate risk of malnutrition. The Short Health Scale (SHS) was used to measure quality of life. Results Malnutrition was detected in 33 patients (10,1 %) and 162 patients (55,0 %) had an increased risk of malnutrition. Malnutrition was associated with lower quality of life in the entire patient cohort and there was no difference between diagnoses. The prevalence of malnutrition was significantly higher among women (73% vs 27 %). Malnourished patients and those at risk of impaired nutritional status were more likely to have had active disease during the preceding 12 months compared to patients without malnutrition or at risk of malnutrition (27 % vs 12% [p=0.015] and 15 % vs 7% [p=0.037] respectively). Surprisingly, a higher calprotectin value was detected among patients without risk of malnutrition when compared to those who were at risk (median 46 [IQR 17 – 106] vs 59 [IQR 25 – 288] respectively, p=0,009). Women with IBD had significantly lower fat-free mass index (FFMI) compared to men. Patients with CD had reduced quality of life compared to patients with UC. Conclusion The prevalence of malnutrition in IBD-outpatients was 10% and more than half of the participants were at risk of malnutrition. Malnutrition was associated with poor quality of life. Malnutrition screening might be important in this population as ongoing inflammation and active disease seem to be apparent even among patients without clear nutrition difficulties or weight problems, but might influence nutritional status and quality of life negatively in the long term. Patients with IBD should therefore be screened for malnutrition and risk of malnutrition on a regular basis.
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STEPHENSON, L. S., M. C. LATHAM, and E. A. OTTESEN. "Global malnutrition." Parasitology 121, S1 (October 2000): S5—S22. http://dx.doi.org/10.1017/s0031182000006478.
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The four most important forms of malnutrition worldwide (protein-energy malnutrition, iron deficiency and anaemias (IDA), vitamin A deficiency (VAD), and iodine deficiency disorders (IDD)) are examined below in terms of their global and regional prevalences, the age and gender groups most affected, their clinical and public health consequences, and, especially, the recent progress in country and regional quantitation and control. Zinc deficiency, with its accompanying diminished host resistance and increased susceptibility to infections, is also reviewed. WHO estimates that malnutrition (underweight) was associated with over half of all child deaths in developing countries in 1995. The prevalence of stunting in developing countries is expected to decline from 36% in 1995 to 32·5% in 2000; the numbers of children affected (excluding China) are expected to decrease from 196·59millions to 181·92millions. Stunting affects 48% of children in South Central Asia, 48% in Eastern Africa, 38% in South Eastern Asia, and 13–24% in Latin America. IDA affects about 43% of women and 34% of men in developing countries and usually is most serious in pregnant women and children, though non-pregnant women, the elderly, and men in hookworm-endemic areas also comprise groups at risk. Clinical VAD affects at least 2·80million preschool children in over 60 countries, and subclinical VAD is considered a problem for at least 251millions; school-age children and pregnant women are also affected. Globally about 740million people are affected by goitre, and over two billions are considered at risk of IDD. However, mandatory salt iodisation in the last decade in many regions has decreased dramatically the percentage of the population at risk. Two recent major advances in understanding the global importance of malnutrition are (1) the data of 53 countries that links protein-energy malnutrition (assessed by underweight) directly to increased child mortality rates, and (2) the outcome in 6 of 8 large vitamin A supplementation trials showing decreases of 20–50% in child mortality.
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JEYASEELAN, L., and M. LAKSHMAN. "RISK FACTORS FOR MALNUTRITION IN SOUTH INDIAN CHILDREN." Journal of Biosocial Science 29, no. 1 (January 1997): 93–100. http://dx.doi.org/10.1017/s002193209700093x.
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Protein energy malnutrition is a major health problem in India and it affects the growth and development of young children. This study investigated the impact of hygiene, housing and sociodemographic variables on acute malnutrition in children aged 5–7, living in urban and rural areas. Ordinal logistic regression analysis showed that the overall prevalence of severe malnutrition was 8·2%. Older age, male sex, mother's poor education, lower family income, higher birth order of the child, use of dung or fire wood as fuel and defecation within the premises were significantly associated with malnutrition. Appropriate intervention programmes should be formulated to educate and support these families.
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Gutiérrez-Gómez, Tranquilina, Ernesto Cortés, Antonio Palazón-Bru, Isabel Peñarrieta-de Córdova, Vicente Francisco Gil-Guillén, and Rosa María Ferrer-Diego. "Six simple questions to detect malnutrition or malnutrition risk in elderly women." PeerJ 3 (October 13, 2015): e1316. http://dx.doi.org/10.7717/peerj.1316.
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Of the numerous instruments available to detect nutritional risk, the most widely used is the Mini Nutritional Assessment (MNA), but it takes 15–20 min to complete and its systematic administration in primary care units is not feasible in practice. We developed a tool to evaluate malnutrition risk that can be completed more rapidly using just clinical variables. Between 2008 and 2013, we conducted a cross-sectional study of 418 women aged ≥60 years from Mexico. Our outcome was positive MNA and our secondary variables included were: physical activity, diabetes mellitus, hypertension, educational level, dentition, psychological problems, living arrangements, history of falls, age and the number of tablets taken daily. The sample was divided randomly into two groups: construction and validation. Construction: a risk table was constructed to estimate the likelihood of the outcome, and risk groups were formed. Validation: the area under the ROC curve (AUC) was calculated and we compared the expected and the observed outcomes. The following risk factors were identified: physical activity, hypertension, diabetes, dentition, psychological problems and living with the family. The AUC was 0.77 (95% CI [0.68–0.86],p< 0.001). No differences were found between the expected and the observed outcomes (p= 0.902). This study presents a new malnutrition screening test for use in elderly women. The test is based on six very simple, quick and easy-to-evaluate questions, enabling the MNA to be reserved for confirmation. However, it should be used with caution until validation studies have been performed in other geographical areas.
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Zhang, Guitao, Yuesong Pan, Runhua Zhang, Mengxing Wang, Xia Meng, Zixiao Li, Hao Li, et al. "Prevalence and Prognostic Significance of Malnutrition Risk in Patients With Acute Ischemic Stroke: Results From the Third China National Stroke Registry." Stroke 53, no. 1 (January 2022): 111–19. http://dx.doi.org/10.1161/strokeaha.121.034366.
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Background and Purpose: To investigate the prevalence of malnutrition risk in patients with acute ischemic stroke (AIS) at admission, the association between malnutrition risk and long-term outcomes, and whether the predictive ability would be improved after adding to previous prognostic models for poor outcomes. Methods: Based on the Third China National Stroke Registry data from August 2015 to March 2018, we evaluated malnutrition risk using objective scores, including the controlling nutritional status score, geriatric nutritional risk index, and prognostic nutritional index. The primary outcome was death or major disability (modified Rankin Scale score ≥3) at 1 year after stroke onset. We calculated the crude prevalence of malnutrition risk and investigated the association between malnutrition risk and clinical outcomes. Prognostic performance of 3 objective malnutrition scores for poor outcomes was assessed. Results: Moderate to severe malnutrition risk was identified in 5.89%, 5.30%, and 1.95% of the Third China National Stroke Registry AIS patients according to the controlling nutritional status score, geriatric nutritional risk index, and prognostic nutritional index, respectively. At 1-year follow-up, 1143 participants (13.5%) experienced death or major disability. After adjustment for traditional risk factors, moderate to severe malnutrition risk was associated with high risk of composite events (odds ratio, 2.25 [95% CI, 1.75–2.90], for controlling nutritional status score; odds ratio, 2.10 [95% CI, 1.63–2.69], for geriatric nutritional risk index; odds ratio, 3.36 [95% CI, 2.33–4.84], for prognostic nutritional index; all P <0.01). Addition of the 3 malnutrition scores to different predicted scales (iScore and Acute Stroke Registry and Analysis of Lausanne) improved predictive ability for long-term poor outcomes validated by the integrated discrimination index (all P <0.05). Conclusions: The prevalence of moderate or severe malnutrition risk in Chinese patients with AIS ranged from 1.95% to 5.89%. Malnutrition risk in patients with AIS was associated with increased risk of long-term death and major disability. Our study provides evidence supporting the prognostic significance of objective malnutrition scores after AIS.
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Andersen, Aino Leegaard, Rikke Lundsgaard Nielsen, Morten Baltzer Houlind, Juliette Tavenier, Line J. H. Rasmussen, Lillian Mørch Jørgensen, Charlotte Treldal, et al. "Risk of Malnutrition upon Admission and after Discharge in Acutely Admitted Older Medical Patients: A Prospective Observational Study." Nutrients 13, no. 8 (August 11, 2021): 2757. http://dx.doi.org/10.3390/nu13082757.
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There is a lack of knowledge about malnutrition and risk of malnutrition upon admission and after discharge in older medical patients. This study aimed to describe prevalence, risk factors, and screening tools for malnutrition in older medical patients. In a prospective observational study, malnutrition was evaluated in 128 older medical patients (≥65 years) using the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment-Short Form (MNA-SF) and the Eating Validation Scheme (EVS). The European Society of Clinical Nutrition (ESPEN) diagnostic criteria from 2015 were applied for diagnosis. Agreement between the screening tools was evaluated by kappa statistics. Risk factors for malnutrition included polypharmacy, dysphagia, depression, low functional capacity, eating-related problems and lowered cognitive function. Malnutrition or risk of malnutrition were prevalent at baseline (59–98%) and follow-up (30–88%). The baseline, follow-up and transitional agreements ranged from slight to moderate. NRS-2002 and MNA-SF yielded the highest agreement (kappa: 0.31 (95% Confidence Interval (CI) 0.18–0.44) to 0.57 (95%CI 0.42–0.72)). Prevalence of risk factors ranged from 17–68%. Applying ESPEN 2015 diagnostic criteria, 15% had malnutrition at baseline and 13% at follow-up. In conclusion, malnutrition, risk of malnutrition and risk factors hereof are prevalent in older medical patients. MNA-SF and NRS-2002 showed the highest agreement at baseline, follow-up, and transitionally.
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FRAGAS, Roberta Flores Marquezini, and Maria Conceição de OLIVEIRA. "Risk factors associated with malnutrition in hospitalized patients." Revista de Nutrição 29, no. 3 (June 2016): 329–36. http://dx.doi.org/10.1590/1678-98652016000300003.
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ABSTRACT Objective To identify factors associated with malnutrition in patients hospitalized in general public hospitals of the city of Manaus, Amazonas, Brazil. Methods This cross-sectional study included 397 patients of both sexes aged more than 18 years, staying at three public hospitals in Manaus, Amazonas. The patients were submitted to anthropometric and subjective global assessments, the latter being the main diagnostic method. For association analyses between malnutrition (dependent variable) and other covariates, we used contingency table for variable selection and multiple logistic regression for independent effect test between exposure and outcome. The strength of association between the variables was expressed as odds ratio, with a 95% confidence interval. The analyses were performed by Epi Info 7.0. Results Among the risk factors associated with hospital malnutrition, hospital stays longer than 15 days, when analyzed alone, nearly tripled the odds of malnutrition. However, in the final model, the variables that remained associated were: persistent change in diet, presence of gastrointestinal symptoms, recent weight loss, weight loss in the last six months, cancer, and age higher than 60 years. Conclusion Malnutrition is recurrent in hospitals, and the factors associated with malnutrition can be identified on admission, allowing adequate monitoring during hospital stay. Therefore, a more effective performance of nutritional screening and monitoring programs is critical.
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Khan, Mazhar, Irum Naz, Farida Shirazi, Rifayat Ullah Afridi, Aneela Ambreen, and Durr E. Nayab. "Risk Factors of Protein Calorie Malnutrition Under Five Years; Tertiary Care Hospitals, Peshawar." Journal of Gandhara Medical and Dental Science 6, no. 2 (March 25, 2020): 3–9. http://dx.doi.org/10.37762/jgmds.6-2.92.
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ABSTRACT:
OBJECTIVES:
The purpose of this study was to know about the risk factors of malnutrition and the incidence of risk factors among known cases of malnutrition admitted in tertiary care hospitals of Peshawar.
METHODOLOGY:
A descriptive cross-sectional study was done. Study was conducted in tertiary care hospitals of Peshawar from March 2019 to July 2019. Study included 100 patients of protein calorie malnutrition less than five years of age. Internationally recognized Gomez classification was used to label patient as malnourished. Risk factors of primary malnutrition including socioeconomic status, ignorance of weaning, poverty, lack of immunization and primary care, maternal illiteracy and risk factors of secondary malnutrition including infections, congenital diseases, malabsorptive disorders and metabolic disorders were assessed. Data was collected through a questionnaire. Tables and graphs were used to determine the frequency of risk factors for protein calorie malnutrition.
RESULTS:
Among 100 patients of PCM 59 were male and 41 were females. After assessment of both genders, risk factors that show close association with protein calorie malnutrition were low socioeconomic status, maternal illiteracy, lack of family planning, poor weaning and repeated infections. Among these risk factors the most frequently observed risk factors for protein calorie malnutrition were low socioeconomic status and repeated infections.
CONCLUSION:
Low socioeconomic condition and repeated infections are the leading cause of protein calorie malnutrition.
KEYWORDS: Malnutrition, Gomez Classification, Frequency, Risk Factors
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Poulimeneas, Dimitrios, Maria G. Grammatikopoulou, Argyri Petrocheilou, Athanasios G. Kaditis, and Tonia Vassilakou. "Triage for Malnutrition Risk among Pediatric and Adolescent Outpatients with Cystic Fibrosis, Using a Disease-Specific Tool." Children 7, no. 12 (December 4, 2020): 269. http://dx.doi.org/10.3390/children7120269.
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Malnutrition prevails in considerable proportions of children with Cystic Fibrosis (CF), and is often associated with adverse outcomes. For this, routine screening for malnutrition is pivotal. In the present cross-sectional study, we aimed to assess the risk for malnutrition in pediatric outpatients with CF. A total of 76 outpatients (44 girls, 11.9 ± 3.9 years old, 39.5% adolescents) were recruited and anthropometric, clinical, dietary and respiratory measures were collected. All outpatients were screened for malnutrition risk with a validated disease-specific instrument. Most children exhibited a low risk for malnutrition (78.9%), whereas none of the participants were characterized as having a high malnutrition risk. In the total sample, malnutrition risk was positively associated with age (r = 0.369, p = 0.001), and inversely related to the body mass index (r = −0.684, p < 0.001), height z-score (r = −0.264, p = 0.021), and forced expiratory volume (FEV1%, r = −0.616, p < 0.001). Those classified as having a low malnutrition risk were younger (p = 0.004), heavier (p < 0.001) and taller (p = 0.009) than their counterparts with a moderate risk. On the other hand, patients in the moderate risk group were more likely pubertal (p = 0.034), with a reduced mid-upper arm fat area (p = 0.011), and worse pulmonary function (p < 0.001). Interestingly, none of the children attaining ideal body weight were classified as having a moderate malnutrition. risk, whereas 37.5% of the patients allocated at the moderate risk group exhibited physiological lung function. In this cohort of outpatients with CF that were predominantly well-nourished and attained physiological lung function, malnutrition risk was identified only in small proportions of the sample. Our data support that patients that are older, pubertal, or have diminished fat mass are at greater risk for malnutrition.
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Carrier, Natalie, Denise Ouellet, and Gale E. West. "Nursing Home Food Services Linked with Risk of Malnutrition." Canadian Journal of Dietetic Practice and Research 68, no. 1 (March 2007): 14–20. http://dx.doi.org/10.3148/68.1.2007.14.
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Purpose: Links between food service characteristics and residents’ risk of malnutrition were examined. Methods: Cognitively intact residents meeting inclusion criteria and living in one of 38 participating nursing homes were randomly sampled. The final sample consisted of 132 residents, who were screened for risk of malnutrition and completed a face-to-face interview questionnaire about dining experiences. Additional data came from participants’ medical charts, and each institution's food service manager completed a written questionnaire. Frequencies and logistic regressions were used to describe the sample and to examine relationships between risk of malnutrition and food service characteristics. Results: Overall, 37.4% of participants were at risk of malnutrition. Food service factors, including food packages, lids, and dishes that were difficult to manipulate (β=0.285, p=0.009), bulk food-delivery systems (β=1.329, p=0.036), overall food satisfaction (β=0.253, p=0.044), menu cycle length (β=-2.162, p=0.003), and porcelain dishes (β=-0.345, p=0.052), all were significantly associated with risk of malnutrition. Conclusions: Our findings clearly show a need for nursing homes to modify certain aspects of food service that may increase the risk of malnutrition among cognitively intact residents.
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Sharashkina, N. V., N. K. Runikhina, and O. N. Tkacheva. "Nurse protocol: nutrition and malnutrition assessment." Russian Journal of Geriatric Medicine, no. 1 (February 14, 2020): 93–97. http://dx.doi.org/10.37586/2686-8636-1-2020-93-97.
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Hospitalized older adults are at risk of malnutrition. Nurses should carefully assess and monitor the nutritional status of the older hospitalized patient so that appropriate nutrition-related interventions can be implemented in timely fashions.Elderly patients are at risk of malnutrition due to dietary, economic, psychological and physiological factors. Older people are at risk of developing malnutrition. This condition or the risk of its development is observed in 39–47% of hospitalized elderly patients. The use of the Mini-Nutritional Assessment (MNA) is recommended to identify malnutrition or the risks of its development. The MNA scale takes into account the diet, patient mobility, BMI, the dynamics of weight loss, psychological stress, acute diseases, dementia and other mental features of the patient.Management plan of a patient with malnutrition: monitoring the implementation of the recommendations of a dietitian, clinical pharmacologist, and other specialists who determine the patient’s nutrition, ensuring adequate supply of nutrients, clinical nutrition (artificial nutrition, special nutritional support, parenteral, enteral nutrition, or a combination thereof), oral administration dietary supplements.
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Safira, Nur Laila, Enny Probosari, Aryu Candra, Fitriyono Ayustaningwarno, and Ayu Rahadiyanti. "HUBUNGAN DISFAGIA DENGAN MALNUTRISI PADA LANJUT USIA : STUDI LITERATUR." Journal of Nutrition College 10, no. 4 (December 9, 2021): 257–72. http://dx.doi.org/10.14710/jnc.v10i4.31008.
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Background: Dysphagia can lead to a decrease in nutritional status and increased risk of malnutrition in the elderly. The incidence of dysphagia often undetected, especially among the elderly in the community, causes the prevalence of the elderly at risk of dysphagia in the elderly to increase.Objective: The aims of this literature study was to review the latest research related to dysphagia with malnutriton in the elderly. Method: The search for 2011 – 2021 English-language articles was carried out on the PubMed, SpringerLink, ScienceDirect, DOAJ, and ResearchGate databases using the keyword Dysphagia AND (Nutritional Status OR Malnutrition) AND Elderly and it was found that 16 articles were selected based on inclusion criteria, including articles with elderly subjects aged ≥65 years in the community, a minimum sample of 50 respondents, a cross sectional and prospective cohort study, analyzed the relationship between variables, and data collection using valid instruments by a trained people.Result: Dysphagia independently had a significant relationship with nutritional status in elderly, could reduce oral food intake and lead to decrease in nutritional status due to nutrient deficiency. It was known that differences in instruments, characteristics and number of samples as well as the timing of malnutrition can affect the relationship between variables. Other factors such as teeth condition, body composition and tongue pressure might also be associated with dysphagia and malnutrition. Conclusion: The existence of a relationship between the two variables found in most of the studies indicates that dysphagia is an important factor that can lead to malnutrition in elderlyKeywords: Elderly; Dysphagia; Malnutrition
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Kvamme, Jan-Magnus, Ole Grønli, Bjarne K. Jacobsen, and Jon Florholmen. "Risk of malnutrition and zinc deficiency in community-living elderly men and women: the Tromsø Study." Public Health Nutrition 18, no. 11 (November 6, 2014): 1907–13. http://dx.doi.org/10.1017/s1368980014002420.
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AbstractObjectiveElderly people may be at particular risk of Zn deficiency due to an increased prevalence of malnutrition. The aim of the present study was to evaluate the Zn status in community-living elderly people at risk of malnutrition.DesignCross-sectional population-based survey. Individuals at risk of malnutrition were identified by the Malnutrition Universal Screening Tool. Zn status was assessed by measuring serum Zn. Logistic regression was performed to evaluate the association between the risk of malnutrition and Zn deficiency.SettingMunicipality of Tromsø, Norway.SubjectsRandom sample of 743 men and 778 women aged 65–87 years.ResultsZn deficiency was found in 10·1 % of the participants, including 13·1 % of the men and 7·3 % of the women. Among the men and women at risk of malnutrition, 31·0 % and 12·7 %, respectively, had Zn deficiency. In a model adjusted for age, gender, serum albumin and smoking status, Zn deficiency was positively associated with the risk of malnutrition (OR=2·2; 95 % CI 1·3, 3·6).ConclusionsOverall, Zn deficiency was found in one out of ten community-living elderly people and was associated with the risk of malnutrition. Our results encourage the assessment of Zn status in elderly people at risk of malnutrition, with a special emphasis on elderly men.
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Park, Jin-Hwa, Minkoo Kang, Dae-Won Jun, Mimi Kim, Joo-Hee Kwak, and Bo-kyeong Kang. "Determining Whether Low Protein Intake (<1.0 g/kg) Is a Risk Factor for Malnutrition in Patients with Cirrhosis." Journal of Clinical Medicine 10, no. 10 (May 17, 2021): 2164. http://dx.doi.org/10.3390/jcm10102164.
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Background: The prevalence of malnutrition in patients with cirrhosis is considerably high. Body mass index (BMI) is a well-known risk factor for malnutrition, but the other risk factors are unknown. We investigated the prevalence of malnutrition and its risk factors in patients with cirrhosis. Methods: In total, 361 patients with cirrhosis were enrolled. Muscle quality and quantity were retrospectively assessed using the grip strength test and bioelectrical impedance analysis. Subjective global assessment (SGA) of malnutrition and dietary intake assessments were performed by a clinical dietician. Results: The prevalence rates of sarcopenia, malnutrition assessed by SGA, and inadequate energy intake were 22.7%, 13.6%, and 27.5%, respectively. The prevalence of malnutrition evaluated using any of the assessment methods was 46.3%, and no significant difference was observed according to liver disease etiology. The prevalence of malnutrition increased with the increasing disease severity (p = 0.034) and decreasing BMI (p = 0.007). The prevalence of malnutrition was 64.4% in patients with protein intake <1.0 g/kg. Low protein intake, Child–Pugh C grade, older age, and low BMI were independent risk factors for malnutrition in multivariate analysis. Conclusions: Low protein intake (<1.0 g/kg) is an independent risk factor for malnutrition in patients with cirrhosis.
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Poudel, Anshu, Nisha K. Bhatta, Mohan Chandra Regmi, Lokraj Shah, and Rajan Paudel. "Assessment of Common Maternal Risk Factors in Fetal Malnutrition." Birat Journal of Health Sciences 6, no. 1 (June 14, 2021): 1377–82. http://dx.doi.org/10.3126/bjhs.v6i1.37641.
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Introduction: Nutritional assessment of the newborn gives the reflection of the growth process in the intrauterine period. The Clinical Assessment of Fetal Nutritional Status score (CAN score) method is only the method to assess the fetal malnutrition which includes the clinical observation for the presence of the sign of malnutrition in newborns. Since the fetal growth is related to availability of intrauterine nutrition and placental function, there may be several maternal factors associated with the fetal malnutrition.
Objectives: The main objective of the study was to determine the prevalance of Fetal Malnutrition in term newborns and the role of maternal factors in the etiology of fetal malnutrition (FM) in the Neonatal and Maternity Units of B.P Koirala Institute of Health Sciences, Dharan.
Methodology: This was a hospital based observational cross sectional study of consecutive, singleton, term live babies delivered between September 2019 to March 2020. Fetal malnutrition was diagnosed using Clinical Assessment of Fetal Nutritional Status score (CAN score) developed by Metcoff. The maternal history was obtained from the mother which included age, parity, socioeconomic class, pre pregnancy weight, number of antenatal care during pregnancy, history of maternal illness and drugs taken during pregnancy. Nutritional status of the mother was determined using weight, height, mid arm circumference (MAC) and the body mass index (BMI). Collected data was entered in Microsoft excel 2010 and converted it into SPSS 23 version software, for statistical analysis.
Results: Of the 400 studied newborns, 73 [18%] had FM. The prevalence of teenage pregnancy, primiparity, lower maternal mid arm circumference and vegetarian diets were higher in the mothers of the babies who had suffered fetal malnutrition than the mothers of the babies without FM (p value <0.05).The adverse maternal condition like Pregnancy induced hypertension (PIH), Antepartum hemorrahge (APH), Urinary tract infection (UTI), fever during pregnancy had significant impact in the fetal malnutrition(p value <0.05).
Conclusion: Improvement in the socioeconomic condition of women and good antenatal care could reduce most of the maternal factors associated with fetal malnutrition. There should be implementation of more accessible programs which address the issues of the maternal nutrition and the maternal health care in Nepal.
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Damião, Renata, Álvaro da Silva Santos, Alicia Matijasevich, and Paulo Rossi Menezes. "Factors associated with risk of malnutrition in the elderly in south-eastern Brazil." Revista Brasileira de Epidemiologia 20, no. 4 (December 2017): 598–610. http://dx.doi.org/10.1590/1980-5497201700040004.
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ABSTRACT: Objective: The aim of this study was to evaluate the prevalence of malnutrition risk and its association with socioeconomic, behavioral, and health characteristics in the community-dwelling elderly. Methods: A cross-sectional study with individuals aged ≥ 60 years. Nutritional status was evaluated using the Mini Nutritional Assessment. Socioeconomic, behavioral, and health information was also collected from all participants. The association between each variable and the risk of malnutrition was calculated and adjusted using Poisson hierarchical regression. Results: The initial sample consisted of 3,101 elderly people, of whom 28.3% (95%CI 25.3 - 31.4%) were at risk of malnutrition. The multivariate analysis showed that the risk of malnutrition was significantly higher in women without formal education, who did not live with a partner, and identified as black-skinned. The risk of malnutrition was twice as high in individuals with no family income as compared to those who earned at least three minimum wages. Smokers were also more likely to be at risk of malnutrition than individuals who had never smoked. Participants suffering from kidney, respiratory or heart disease were at higher risk of malnutrition than those with no history of such illnesses. Conclusion: These findings could be used to help in the development of health policies and in the establishment of adequate programs aimed at reducing the risk of malnutrition in this population.
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Rosa, Carolina Böettge, Solange Beatriz Billig Garces, Dinara Hansen, Ângela Vieira Brunelli, Patrícia Dall’Agnol Bianchi, Janaina Coser, Marília de Rosso Krug, and Carla Helena Augustin Schwanke. "Malnutrition risk and hospitalization in elderly assisted in Primary Care." Ciência & Saúde Coletiva 22, no. 2 (February 2017): 575–82. http://dx.doi.org/10.1590/1413-81232017222.15732016.
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Abstract The aim of this study was to investigate the association of malnutrition risk and single items of the Mini Nutritional Assessment (MNA®) with hospitalization in the last 12 months in the elderly assisted in primary care. A cross-sectional study was conducted with the evaluation of 1229 elderly persons assisted in Family Health Strategies in seven cities of South Brazil. Malnutrition risk was evaluated using the MNA®, and hospitalization was determined by one question of the Probability of Repeated Admission (PRA) instrument. Most of the elderly were women (61.7%), with a mean age of 71.7 ± 7.7 years. The malnutrition risk rate was 23.3% and hospitalization was 32.9%. The frequency of malnutrition and risk of malnutrition was two times greater among the elderly who were hospitalized (36.8 versus 18.6% - P < 0.001). There was a significant association between hospitalization and 11 (64.7%) of the 17 items on the MNA® evaluated (P < 0.05). Of these, seven items were independently associated with hospitalization by multivariate analysis. We observed an association of malnutrition risk and most of the single MNA® items as well, with hospitalization in the elderly assisted in primary care.
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van Vliet, Iris M. Y., Antonio W. Gomes-Neto, Margriet F. C. de Jong, Stephan J. L. Bakker, Harriët Jager-Wittenaar, and Gerjan J. Navis. "Malnutrition screening on hospital admission: impact of overweight and obesity on comparative performance of MUST and PG-SGA SF." European Journal of Clinical Nutrition 75, no. 9 (February 15, 2021): 1398–406. http://dx.doi.org/10.1038/s41430-020-00848-4.
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Abstract Background/objectives Traditional malnutrition screening instruments, including the Malnutrition Universal Screening Tool (MUST), strongly rely on low body mass index (BMI) and weight loss. In overweight/obese patients, this may result in underdetection of malnutrition risk. Alternative instruments, like the Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF), include characteristics and risk factors irrespective of BMI. Therefore, we aimed to compare performance of MUST and PG-SGA SF in malnutrition risk evaluation in overweight/obese hospitalized patients. Subjects/methods We assessed malnutrition risk using MUST (≥1 = increased risk) and PG-SGA SF (≥4 = increased risk) in adult patients at hospital admission in a university hospital. We compared results for patients with BMI < 25 kg/m2 vs. BMI ≥ 25 kg/m2. Results Of 430 patients analyzed (58 ± 16 years, 53% male, BMI 26.9 ± 5.5 kg/m2), 35% were overweight and 25% obese. Malnutrition risk was present in 16% according to MUST and 42% according to PG-SGA SF. In patients with BMI < 25 kg/m2, MUST identified 31% as at risk vs. 52% by PG-SGA SF. In patients with BMI ≥ 25 kg/m2, MUST identified 5% as at risk vs. 36% by PG-SGA SF. Agreement between MUST and PG-SGA SF was low (к = 0.143). Of the overweight/obese patients at risk according to PG-SGA SF, 83/92 (90%) were categorized as low risk by MUST. Conclusions More than one-third of overweight/obese patients is at risk for malnutrition at hospital admission according to PG-SGA SF. Most of them are not identified by MUST. Awareness of BMI-dependency of malnutrition screening instruments and potential underestimation of malnutrition risk in overweight/obese patients by using these instruments is warranted.
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Syuhada, Khreshna, Dessie Wanda, Risti Nur’aini, Chairun Ardiantari, and Ayu Susilo. "Statistical Risk Characteristics and Risk Scoring of Hospital-Acquired Malnutrition for Pediatric Patients." Journal of Nutrition and Metabolism 2020 (June 9, 2020): 1–8. http://dx.doi.org/10.1155/2020/4305487.
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Background. Malnutrition is a global health problem and challenge for every country. It may occur in any form and affect all levels of age including children. We pay particular attention to the so-called hospital-acquired malnutrition (HaM) for pediatric patients. Our aim was to explore statistical risk factors or characteristics as well as to forecast risk scoring for such malnutrition. Methods. This study employed a cross-sectional design involving children from 1 month to 18 years of age who were hospitalized for at least 72 hours. We used secondary data from 308 medical records of pediatric patients who were admitted to the hospital in 2017. We excluded the data if the patient had tumors or organomegaly, fluid retention, and dehydration. HaM was determined based on a weight loss each day during hospitalization until the day of discharge. Statistical data analysis is carried out for both descriptive and inferential statistics. Our predictive model is yielded by linear regression, and risk scoring is obtained through logistic regression. Results. The findings showed several risk factors or characteristics for HaM prevalence: sex, age, medical diagnosis, diet, nutrition route, and NEWS score. The early warning system to pediatric patients is conducted by calculating malnutrition-at-risk in which a value beyond 100.5 is considered as having high potential risk for HaM. Conclusion. Nurses are expected to monitor pediatric patients’ condition, including measuring the anthropometry regularly, in order to identify the initial signs of HaM.
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Sudarmanto, Bambang, and Citra Primavita. "Disease-related malnutrition in children with cancer: What’s the risk and the impact on patient's outcome?" World Nutrition Journal 5, no. i2 (February 28, 2022): 42–51. http://dx.doi.org/10.25220/wnj.v05.i2.0007.
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Background: Malnutrition in children with cancer is a common problem, particularly in low-income countries. Risk factors, effects on outcome, and feasible interventions are important to comprehend in managing patients.
Objectives: To know the risk and impact of malnutrition in children with patients.
Discusion: Children with cancer are at risk of suffering from malnutrition. Malnutrition occurs due to energy imbalance and results from multifactorial interactions, including type of tumors and therapy. Malnutrition can contribute to poor clinical outcome and decreased quality of life. Management of malnutrition in pediatric patients with cancer include screening and nutritional interventions with suitable route of administration based on patient condition.
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Avila, Jaqueline C., Rafael Samper-Ternent, and Rebeca Wong. "Malnutrition Risk among Older Mexican Adults in the Mexican Health and Aging Study." Nutrients 13, no. 5 (May 12, 2021): 1615. http://dx.doi.org/10.3390/nu13051615.
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Few studies assess the malnutrition risk of older Mexican adults because most studies do not assess nutritional status. This study proposes a modified version of the Mini Nutritional Assessment (MNA) to assess the risk of malnutrition among older Mexicans adults in the Mexican Health and Aging Study (MHAS). Data comes from the 2012, 2015, and 2018 waves of the MHAS, a nationally representative study of Mexicans aged 50 and older. The sample included 13,338 participants and a subsample of 1911 with biomarker values. ROC analysis was used to calculate the cut point for malnutrition risk. This cut point was compared to the definition of malnutrition from the ESPEN criteria, BMI, low hemoglobin, or low cholesterol. Logistic regression was used to assess predictors of malnutrition risk. A score of 10 was the optimal cut point for malnutrition risk in the modified MNA. This cut point had high concordance to identify malnutrition risk compared to the ESPEN criteria (97.7%) and had moderate concordance compared to BMI only (78.6%), and the biomarkers of low hemoglobin (56.1%) and low cholesterol (54.1%). Women, those older than 70, those with Seguro Popular health insurance, and those with fair/poor health were more likely to be malnourished. The modified MNA is an important tool to assess malnutrition risk in future studies using MHAS data.
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Madril, Peter, Paige Golian, Marcia Nahikian-Nelms, Alice Hinton, Philip A. Hart, and Kristen M. Roberts. "Identification of Malnutrition Risk Using Malnutrition Screening Tool in an Ambulatory Pancreas Clinic." Pancreas 51, no. 1 (January 2022): 94–99. http://dx.doi.org/10.1097/mpa.0000000000001954.
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Einav, L., A. Hirsch, Y. Ron, N. Aviv Cohen, R. Anbar, S. Lahav, N. Maharshak, and N. Fliss Isakov. "P511 Disease-specific risk factors for malnutrition development in IBD." Journal of Crohn's and Colitis 15, Supplement_1 (May 1, 2021): S491—S492. http://dx.doi.org/10.1093/ecco-jcc/jjab076.633.
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Abstract Background Patients with inflammatory bowel diseases (IBD) are at risk of malnutrition, which is associated with considerable disease related complications. Most available screening tools for malnutrition risk such as the malnutrition universal screening tool (MUST), do not incorporate malnutrition-promoting characteristics of IBDs. Therefore, we aimed to detect disease-specific risk factors for malnutrition development in IBD, which may be incorporated in future malnutrition screening tools. Methods A retrospective case-control study, in which detailed information regarding IBD patients treated at the IBD clinic of the Tel-Aviv Medical Center between 2010–2020 was collected. Cases were patients who developed malnutrition between clinic visits (defined as BMI≤18.5/ weight loss ≥5% of body weight during 3 months/≥10% of body weight during 6 months) and controls were those who maintained a normal nutritional status. Cases and controls were matched by age, gender, disease and disease duration. Data was collected from medical files included reported medical history, clinical manifestations of disease, disease activity, and nutritional status including MUST evaluation during clinic visits. The association between the clinical data and malnutrition development was evaluated using a logistic regression model, with adjustment for MUST components: weight loss of ≥5% of body weight and multiple (≥2) reasons for inadequate nutritional intake. Results We collected data from 118 IBD patient (cases, n=59 and controls n= 59, Crohn’s disease n=76, ulcerative colitis n=28, pouchitis patients n=14). All patients were at normal nutritional status at baseline. Patients were followed for a period of 6.2±3.0 months during which, cases lost 5.3±2.3 kg (10.4±4.8 % body weight) and controls gained 0.2±2.3 kg )0.2±3.5 % body weight) (p<0.001). MUST screening misclassified 34% of cases as low risk for malnutrition. Development of malnutrition was positively associated with baseline endoscopic disease activity [Odds ratio (OR)=6.06, 95% Confidence interval (CI) 1.91–19.18], repeated physician/nurse clinic visits ≥4/year (OR=5.26, 1.20–22.98), and negatively associated with advanced therapy (biologics and small molecules) (OR=0.151, 0.03–0.70), and BMI at baseline (OR=0.24, 0.13–0.44). The fit of this model was evaluated by an area under the curve of AUC=0.961 CI 0.93–0.99, p<0.001. Conclusion Current tools for prediction of malnutrition among IBD patients are not sensitive enough. Parameters, such as increased disease activity should prompt nutritional assessment among patients to prevent mal-nutrition. The importance of these findings should be evaluated in prospective studies.
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Kiesswetter, Eva, Miriam G. Colombo, Christa Meisinger, Annette Peters, Barbara Thorand, Rolf Holle, Karl-Heinz Ladwig, et al. "Malnutrition and related risk factors in older adults from different health-care settings: an enable study." Public Health Nutrition 23, no. 3 (August 27, 2019): 446–56. http://dx.doi.org/10.1017/s1368980019002271.
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AbstractObjective:The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition.Design:Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression.Setting:Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH).Participants:CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years.Results:Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors.Conclusions:The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.
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Ben-Ishay, Offir, Haya Gertsenzon, Tanya Mashiach, Yoram Kluger, and Irit Chermesh. "Malnutrition in Surgical Wards: A Plea for Concern." Gastroenterology Research and Practice 2011 (2011): 1–4. http://dx.doi.org/10.1155/2011/840512.
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Background. Malnutrition in hospitalized patients is underdiagnosed, with 30 to 60% of patients admitted being malnourished. The objective of this study was to investigate the nutritional status of patients in a general surgery ward and to define the correlation between the risk of malnutrition and the hospital course and clinical outcome.Study design. The study group included 100 consecutive patients admitted to a general surgery ward who were ambulant and could undergo the Malnutrition Universal Screening Tool (MUST).Results. Thirty-two patients (33%) had aMUST score of 2 or higher, and were therefore defined at high-malnutrition risk. The patients at risk had longer hospitalization and worse outcome. The length of stay of the malnourished patients was significantly longer than that of patients without malnutrition risk (18.8 11.5 vs. 7 5.3 days, ). Mortality in the high-risk group was higher overall, in hospital, and after six months and one year of followup.Conclusions. Medical personnel must be aware that malnutrition afflicts even patients whose background is not suggestive of malnutrition. Best results are achieved when cooperation of all staff members is enlisted, because malnutrition has severe consequences and can be treated easily.
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Khaing, Hnin Thiri, Shuhei Nomura, Daisuke Yoneoka, Peter Ueda, and Kenji Shibuya. "Risk factors and regional variations of malnutrition among children under 5 in Myanmar: cross-sectional analyses at national and subnational levels." BMJ Open 9, no. 9 (September 2019): e030894. http://dx.doi.org/10.1136/bmjopen-2019-030894.
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ObjectiveThe levels, distributions of child malnutrition and its potential risk factors are not very well known in Myanmar. The objectives included in this study were: to estimate the current national and subnational prevalence of four types of malnutrition (stunting, wasting, underweight and overweight) among children under 5 in Myanmar; to identify potential risk factors associated with each type of malnutrition and to investigate how the identified risk factors’ distributions explained the regional disparities in malnutrition prevalence.Design/methodsData from the Myanmar Demographic and Health Survey 2015–2016 were used to estimate the prevalence of four types of malnutrition at both national and subnational levels (15 regions). Logistic regression models were applied to examine the association between each type of malnutrition and its risk factors, including child’s factors, parental social status and household conditions. The risk factor-adjusted prevalence of the malnutrition was estimated at the subnational level based on the estimated parameters from the regression models.ResultsThe national prevalence of stunting, wasting, underweight and overweight in children under 5 was estimated to be 29.1% (95% CI 27.7% to 30.6%), 6.8% (6.0% to 7.6%), 18.3% (17.0% to 19.5%) and 1.5% (1.1% to 1.9%), respectively. Substantial regional variations in the prevalence of each type of malnutrition were observed. Several risk factors of each type of malnutrition were identified, including low birth weight (LBW) and inadequate maternal nutritional status. Except for overweight, regional variations largely persisted even after adjustment for the risk factors investigated.ConclusionThe prevalence of malnutrition among children under 5 is still high in Myanmar, most commonly stunting. Targeted interventions aimed at prevention of LBW, improving the maternal nutritional status, in addition to other sociodemographic conditions should be encouraged urgently. Further research is necessary to investigate the potential sources of regional variation in prevalence of malnutrition among children under 5 in the country.
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Guigoz, Yves, Sylvie Lauque, and Bruno J. Vellas. "Identifying the elderly at risk for malnutrition." Clinics in Geriatric Medicine 18, no. 4 (November 2002): 737–57. http://dx.doi.org/10.1016/s0749-0690(02)00059-9.
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Worcester, Sharon. "Maternal Malnutrition, Smoking Raise Fetal Gastroschisis Risk." Internal Medicine News 39, no. 2 (January 2006): 24. http://dx.doi.org/10.1016/s1097-8690(06)72683-x.
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Tomkins, Andrew M. "Protein–energy malnutrition and risk of infection." Proceedings of the Nutrition Society 45, no. 3 (September 1986): 289–304. http://dx.doi.org/10.1079/pns19860067.
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Falutz, Julian, Allan Huang, Lisa Callow, and Donna Haddad. "A Short Questionnaire Estimating Risk of Malnutrition." Journal of the American Geriatrics Society 40, no. 9 (September 1992): 976. http://dx.doi.org/10.1111/j.1532-5415.1992.tb02001.x.
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Alves, S. C., R. Salvado, and C. V. Oliveira. "Risk of malnutrition and other co-morbidities." European Journal of Internal Medicine 24 (October 2013): e262. http://dx.doi.org/10.1016/j.ejim.2013.08.677.
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