Description of the etiological factors behind acute moderate and severe malnutrition in children under 5 years hospitalized at two high-complexity referral centers: Case series.

BACKGROUND: Acute malnutrition in children <5 years of age has a direct relationship with medical complications and mortality. We aimed to describe the etiologic factors in children with moderate and severe non-illness-related acute malnutrition who required hospitalization for treatment of malnutrition in two high-complexity hospital centers in Bogotá, Colombia. METHODS: This is a multicenter case series (December 2016 to December 2020) including patients aged 1-59 months with a weight/height indicator less than -2 SD. Electronic health records were reviewed, and demographic (sex, age, city of origin, and socioeconomic status) and clinical data (gestational age at birth, edema, and nutrition status) were collected. Descriptive analysis of information was performed. An exploratory bivariate analysis by diagnostic categories of moderate and severe acute malnutrition vs days of hospitalization was also performed. RESULTS: Forty-five patients were included, 62.2% of whom were male, with a median age of 14 months (Q1-Q3: 7-24). The main etiologic factors of malnutrition were related to problems with total food intake (33.3%), transition in consistency of feeding (31.1%), and breastfeeding technique (22.2%). Only 13.3% had problems related to food insecurity. There were no statistically significant differences between moderate (median: 7 days; Q1-Q3: 5-12) and severe (median: 8 days; Q1-Q3: 5-16) acute malnutrition when compared by days of hospitalization. CONCLUSIONS: The main etiologic factors of malnutrition in our study population were related to problems in the amount of food provided and transition in consistency of complementary feeding.

Malnutrition screening tool and nutritional screening tool for classification of nutritional risk in patients with cancer upon hospital admission: Comparison of diagnostic performance using Global Leadership Initiative on malnutrition criteria as reference.

BACKGROUND & AIMS: Tools for screening of nutrition risk in patients with cancer are usually validated against other screening instruments. Here with the performance of Malnutrition Screening Tool (MST) and Nutritional Screening Tool (NUTRISCORE) to identify the risk of malnutrition was assessed. A full nutritional evaluation and diagnosis following criteria from the Global Leadership Initiative of Malnutrition (GLIM) was the reference standard for the classification of malnutrition. METHODS: Diagnostic test prospective analysis of adult patients with a confirmed diagnosis of cancer. MST, NUTRISCORE and nutritional evaluation and diagnosis by GLIM criteria were independently performed within 24 h of admission to a 4th tier hospital in Bogotá, Colombia. RESULTS: From 439 patients the sensitivity and specificity of MST was 75% and 94% and of NUTRISCORE 45% and 97% respectively. The area under receiver operating characteristic (ROC) curves were 0.90 for MST and 0.85 for NUTRISCORE (p = 0.003). CONCLUSION: The MST showed a significantly better diagnostic performance over NUTRISCORE for detection of malnutrition risk at admission to hospital of patients with cancer.

Herramientas para identificar consumo y desperdicio de la dieta hospitalaria. Revisión Sistemática

RESUMEN Introducción: Uno de los factores que influyen en la desnutrición hospitalaria es la incapacidad del paciente para alimentarse correctamente. Un bajo consumo de la dieta hospitalaria aumenta el riesgo a sufrir complicaciones de salud, además genera impacto económico y ambiental, producto del aumento de desperdicio de alimentos. Generar estrategias encaminadas a mitigar este problema debe ser prioridad para el sector salud. Objetivo: Identificar herramientas técnicas utilizadas para medir el consumo y/o desperdicio de alimentos en la dieta hospitalaria. Materiales y métodos: Búsqueda sistemática de estudios publicados en las bases de datos de EMBASE y MEDLINE a través de la plataforma Pubmed, en febrero del 2019, temporalidad 20 años. Se buscaron por términos controlados sobre dieta hospitalaria, desperdicio de alimentos y la satisfacción del paciente. Resultados: Se encontraron 410 artículos en inglés, español y portugués. Se seleccionaron 21 artículos para análisis de texto completo por cumplimiento de criterios de selección. Conclusiones: Las herramientas encontradas para la medición del desperdicio de alimentos se basaron principalmente en el pesaje, y la medición visual ya sea directa o por imágenes; otras aproximaciones incluyeron cuestionarios y métodos de múltiples componentes, la mayoría sin hacer discriminación del componente alimenticio desperdiciado.

ABSTRACT Introduction: One of the factors that influences hospital malnutrition is the inability of the patient to eat properly. A low consumption of the hospital diet increases the risk of suffering health complications, in addition to generating an economic and environmental impact, as a result of the increase in food waste. Generating strategies aimed at mitigating this problem should be a priority for the health sector. Objective: Identify technical tools used to measure food consumption and / or waste in the hospital diet. Materials and methods: Systematic search for studies published in the EMBASE and MEDLINE databases through the Pubmed platform was conducted in February 2019, searching articles published in the last 20 years. We searched for controlled terms on hospital diet, food waste, and patient satisfaction. Results: 410 articles were found in English, Spanish and Portuguese. Twenty-one articles were selected for full-text analysis by meeting the selection criteria. Conclusions: The tools found for the measurement of food consumption were based mainly on weighing, and visual measurement either direct or by images; other approaches included questionnaires and multi-component methods, most of the tools did not discriminate the food component wasted.