Hospital-acquired malnutrition: point prevalence, risk identifiers and utility of a digital Dashboard to identify high-risk, long-stay patients in five Australian facilities

IF 2.9 3区医学 Q3 NUTRITION & DIETETICS

Journal of Human Nutrition and Dietetics Pub Date : 2024-10-01 DOI:10.1111/jhn.13376

Michelle Palmer, Breanne Hosking, Fiona Naumann, Sally Courtice, Amanda Henderson, Rachel M. Stoney, Lynda J. Ross, Angela Vivanti

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Abstract

Background

There are limited hospital-acquired malnutrition (HAM) studies among the plethora of malnutrition literature, and a few studies utilise electronic medical records to assist with malnutrition care. This study therefore aimed to determine the point prevalence of HAM in long-stay adult patients across five facilities, whether any descriptors could assist in identifying these patients and whether a digital Dashboard accurately reflected ‘real-time’ patient nutritional status.

Methods

HAM was defined as malnutrition first diagnosed >14 days after hospital admission. Eligible patients were consenting adult (≥18 years) inpatients with a length of stay (LOS) >14 days. Palliative, mental health and intensive care patients were excluded. Descriptive, clinical and nutritional data were collected, including nutritional status, and whether a patient had hospital-acquired malnutrition to determine point prevalence. Descriptive Fisher's exact and analysis of variance (ANOVA) tests were used.

Results

Eligible patients (n = 134) were aged 68 ± 16 years, 52% were female and 92% were acute admissions. HAM and malnutrition point prevalence were 4.5% (n = 6/134) and 19% (n = 26/134), respectively. Patients with HAM had 72 days greater LOS than those with malnutrition present on admission (p < 0.001). A high proportion of HAM patients were inpatients at a tertiary facility and longer-stay wards. The Dashboard correctly reflected recent ward dietitian assessments in 94% of patients at one facility (n = 29/31).

Conclusions

HAM point prevalence was 4.5% among adult long-stay patients. Several descriptors may be suitable to screen for at-risk patients in future studies. Digital Dashboards have the potential to explore factors related to HAM.

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医院获得性营养不良：点流行率、风险识别器和数字仪表板的实用性，以识别澳大利亚五家医疗机构中的高风险、长期住院患者。

背景：在大量营养不良文献中，关于医院获得性营养不良（HAM）的研究非常有限，利用电子病历协助营养不良护理的研究也寥寥无几。因此，本研究旨在确定五家医疗机构中长期住院成人患者营养不良的发病率，是否有任何描述指标可帮助识别这些患者，以及数字仪表板是否能准确反映患者的 "实时 "营养状况。符合条件的患者均为同意入院且住院时间（LOS）大于 14 天的成年（≥18 岁）住院患者。姑息治疗、精神疾病和重症监护患者除外。研究人员收集了描述性数据、临床数据和营养数据，包括营养状况以及患者是否有医院获得性营养不良，以确定点流行率。采用了描述性费雪精确检验和方差分析（ANOVA）检验：符合条件的患者（n = 134）年龄为 68 ± 16 岁，52% 为女性，92% 为急性入院患者。HAM和营养不良点患病率分别为4.5%（n = 6/134）和19%（n = 26/134）。与入院时存在营养不良的患者相比，HAM 患者的生命周期长 72 天（P 结论：HAM 患者的生命周期比营养不良患者长 72 天）：在长期住院的成人患者中，HAM 的发病率为 4.5%。在未来的研究中，一些描述指标可能适合用于筛查高危患者。数字仪表板有可能探索与 HAM 相关的因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Human Nutrition and Dietetics 医学-营养学

CiteScore

5.30

自引率

15.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Human Nutrition and Dietetics is an international peer-reviewed journal publishing papers in applied nutrition and dietetics. Papers are therefore welcomed on: - Clinical nutrition and the practice of therapeutic dietetics - Clinical and professional guidelines - Public health nutrition and nutritional epidemiology - Dietary surveys and dietary assessment methodology - Health promotion and intervention studies and their effectiveness - Obesity, weight control and body composition - Research on psychological determinants of healthy and unhealthy eating behaviour. Focus can for example be on attitudes, brain correlates of food reward processing, social influences, impulsivity, cognitive control, cognitive processes, dieting, psychological treatments. - Appetite, Food intake and nutritional status - Nutrigenomics and molecular nutrition - The journal does not publish animal research The journal is published in an online-only format. No printed issue of this title will be produced but authors will still be able to order offprints of their own articles.