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Open AccessArticle

Hospital Malnutrition, a Call for Political Action: A Public Health and NutritionDay Perspective

1
Division Cardio-thoracic and Vascular Anesthesia and Intensive Care, Medical University Vienna, 1090 Vienna, Austria
2
Center for Medical Statistics, Informatics and Intelligent Systems, Medical University Vienna, 1090 Vienna, Austria
3
Department of Health Economics, Center for Public Health, Medical University Vienna, 1090 Vienna, Austria
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Department of Internal Medicine III, Medical University Vienna, 1090 Vienna, Austria
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Department of Translational and Precision Medicine, Università degli Studi di Roma “La Sapienza”, 00185 Roma, Italy
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Institute for Biomedicine of Ageing, Friedrich-Alexander Universität Erlangen-Nürnberg, 90408 Nürnberg, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(12), 2048; https://doi.org/10.3390/jcm8122048
Received: 29 September 2019 / Revised: 11 November 2019 / Accepted: 14 November 2019 / Published: 22 November 2019
Disease-related malnutrition (DRM) is prevalent in hospitals and is associated with increased care needs, prolonged hospital stay, delayed rehabilitation and death. Nutrition care process related activities such as screening, assessment and treatment has been advocated by scientific societies and patient organizations but implementation is variable. We analysed the cross-sectional nutritionDay database for prevalence of nutrition risk factors, care processes and outcome for medical, surgical, long-term care and other patients (n = 153,470). In 59,126 medical patients included between 2006 and 2015 the prevalence of recent weight loss (45%), history of decreased eating (48%) and low actual eating (53%) was more prevalent than low BMI (8%). Each of these risk factors was associated with a large increase in 30 days hospital mortality. A similar pattern is found in all four patient groups. Nutrition care processes increase slightly with the presence of risk factors but are never done in more than 50% of the patients. Only a third of patients not eating in hospital receive oral nutritional supplements or artificial nutrition. We suggest that political action should be taken to raise awareness and formal education on all aspects related to DRM for all stakeholders, to create and support responsibilities within hospitals, and to create adequate reimbursement schemes. Collection of routine and benchmarking data is crucial to tackle DRM. View Full-Text
Keywords: malnutrition; hospital; nutrition care; continuity of care; mortality; process indicators; benchmarking; disease related malnutrition. malnutrition; hospital; nutrition care; continuity of care; mortality; process indicators; benchmarking; disease related malnutrition.
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Hiesmayr, M.; Tarantino, S.; Moick, S.; Laviano, A.; Sulz, I.; Mouhieddine, M.; Schuh, C.; Volkert, D.; Simon, J.; Schindler, K. Hospital Malnutrition, a Call for Political Action: A Public Health and NutritionDay Perspective. J. Clin. Med. 2019, 8, 2048.

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