Assessment of Nutrient Levels Provided by General Hospital Patient Menus: A Cross-Sectional Study Carried Out in the Region of Murcia (Spain).

Disease-related malnutrition remains a health problem with a high prevalence that increases the risk of poor patient outcomes, in addition to an elevation of healthcare costs. The aim of this study was to evaluate the nutritional quality of the menus at Ribera Molina Hospital, including their adequacy regarding recommended daily nutrient intakes and the agreement with the theoretical nutrition information provided by catering. The mean levels of energy, macronutrients, vitamins, and minerals provided by the basal, diabetic, and soft diets were calculated through the weighing of plated food served throughout the first 14 days of February 2020. A nutritional overestimation was seen in the nutrition information provided by the catering compared to the values derived from weighing foods (p < 0.01). Despite this, the nutritional content calculated by weighing satisfied the energy and protein requirements of 203 hospitalized patients previously studied in the internal medicine area of the hospital. The mean age of these patients was 62 years, and the main causes of admission were lung, cardiovascular, renal, and digestive diseases. There seems to be an insufficient amount of vitamins E and D, as well as magnesium, on all the menus. A possible insufficient amount of calcium, potassium, zinc, and copper was observed in some of the menus studied. It is necessary to update the hospital prescription manual so the nutritional contents of the diets are accurate and based on the weighted and calculated values to improve the adequacy of diets prescribed to patients.

Phase Angle, Handgrip Strength, and Other Indicators of Nutritional Status in Cancer Patients Undergoing Different Nutritional Strategies: A Systematic Review and Meta-Analysis.

Malnutrition in cancer patients is one of the most influential factors in the evolution and mortality of such patients. To reduce the incidence of malnutrition, it is necessary to establish a correct nutritional intervention. For this purpose, precise tools and indicators must be developed to determine the patient's condition. The main objective of this systematic review and meta-analysis was to analyze the relationship between different nutritional strategies, phase angle (PA), and handgrip strength in patients with cancer, with the secondary objectives being the modification of other indicators of nutritional status, such as weight and body mass index (BMI). A systematic review of randomized clinical trials was carried out in March 2023 in the databases PubMed, Web of Science, Cochrane, and Scopus. As a risk-of-bias tool, RoB 2.0 was utilized. A total of 8 studies with a total of 606 participants were included in the analysis. A significant increase in PA was observed after the different nutritional strategies (SMD: 0.43; 95% CI: 0.10 to 0.77; p = 0.01; I2 = 65.63%), also detecting a significant increase in handgrip strength (SMD: 0.27, 95% CI: 0.08 to 0.47; p = 0.01; I2 = 30.70%). A significant increase in PA and handgrip were observed in cancer patients subjected to different nutritional strategies. These results suggest that these indicators could be used in the nutritional and functional assessment of the patients.

Desnutrición relacionada con la enfermedad, parámetros funcionales y costes asociados en un hospital general / Disease-related malnutrition, functional parameters, and associated costs in a genaral hospital

Introducción: la desnutrición relacionada con la enfermedad (DRE) afecta en Europa a más de 30 millones de personas, lo que supone cada año unos 170.000 millones de euros. Es necesario implantar protocolos multidisciplinares para el abordaje de la DRE. Objetivo: estudiar la proporción de pacientes afectados o en riesgo de DRE al ingreso, la duración y el coste de su estancia en un hospital general.Métodos: estudio observacional de corte transversal con un tamaño muestral de 203 sujetos. De junio a diciembre de 2018 se realizó un cribado nutricional conforme al Nutritional Risk Screening 2002 (NRS-2002), se hizo un diagnóstico según los criterios de la Iniciativa de Liderazgo Mundial en Desnutrición (GLIM), se registró la duración del ingreso y se efectuó una estimación del coste de la estancia de todos los pacientes que ingresaron en medicina interna y cumplían los criterios de selección. Resultados: la proporción de personas en riesgo de DRE fue del 28 % (57/203; IC 95 %: 22 % a 34 %). La proporción de pacientes con diagnóstico de DRE fue del 19 % (36/192; IC 95 %: 13 % a 24 %). Los pacientes clasificados con riesgo o diagnóstico de DRE al ingreso tuvieron una estancia 3 días mayor que la de los normonutridos (p < 0,01) y un coste mayor que el de los normonutridos en 1.803,66 euros (p < 0,01). Conclusiones: se hace necesario un abordaje integral y multidisciplinar de la DRE coordinada desde la Comunidad, la Atención Primaria y los hospitales, especialmente en las mujeres de ≥ 70 años con patología pulmonar. (AU)

Introduction: disease-related malnutrition (DRM) affects more than 30 million people in Europe, representing about 170 billion euros each year. Despite the growing consensus for the diagnosis of DRM, it is still necessary to implement multidisciplinary and coordinated protocols for a comprehensive approach to DRM in hospitals. Objetive: to study the proportion of patients affected by DRM upon admission, as well as the duration and the cost of their stay in a general hospital. Methods: an observational cross-sectional study with a sample size of 203 subjects. From June to December 2018, a nutritional screening was carried out according to the Nutritional Risk Screening 2002 (NRS-2002); diagnoses were made according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, length of stay was recorded, and the cost of stay was estimated for all patients admitted to Internal Medicine who met the selection criteria. Results: the proportion of people at risk of DRM was 28 % (57/203; 95 % CI: 22 % to 34 %). The proportion of patients diagnosed with DRM was 19 % (36/192; 95 % CI: 13 % to 24 %). Patients classified with risk or diagnosis of DRM upon admission had a longer stay than those with normal nutrition by 3 days (p < 0.01), and a higher cost by €1,803.66 (p < 0.01). Conclusions: a comprehensive, multidisciplinary approach to DRM coordinated from Primary Care to hospitals is necessary, especially in women aged ≥ 70 years with pulmonary disease. (AU)

[Disease-related malnutrition, functional parameters, and associated costs in a genaral hospital]. / Desnutrición relacionada con la enfermedad, parámetros funcionales y costes asociados en un hospital general.

INTRODUCTION: Introduction: disease-related malnutrition (DRM) affects more than 30 million people in Europe, representing about 170 billion euros each year. Despite the growing consensus for the diagnosis of DRM, it is still necessary to implement multidisciplinary and coordinated protocols for a comprehensive approach to DRM in hospitals. Objetive: to study the proportion of patients affected by DRM upon admission, as well as the duration and the cost of their stay in a general hospital. Methods: an observational cross-sectional study with a sample size of 203 subjects. From June to December 2018, a nutritional screening was carried out according to the Nutritional Risk Screening 2002 (NRS-2002); diagnoses were made according to the Global Leadership Initiative on Malnutrition (GLIM) criteria, length of stay was recorded, and the cost of stay was estimated for all patients admitted to Internal Medicine who met the selection criteria. Results: the proportion of people at risk of DRM was 28 % (57/203; 95 % CI: 22 % to 34 %). The proportion of patients diagnosed with DRM was 19 % (36/192; 95 % CI: 13 % to 24 %). Patients classified with risk or diagnosis of DRM upon admission had a longer stay than those with normal nutrition by 3 days (p < 0.01), and a higher cost by €1,803.66 (p < 0.01). Conclusions: a comprehensive, multidisciplinary approach to DRM coordinated from Primary Care to hospitals is necessary, especially in women aged ≥ 70 years with pulmonary disease.

INTRODUCCIÓN: Introducción: la desnutrición relacionada con la enfermedad (DRE) afecta en Europa a más de 30 millones de personas, lo que supone cada año unos 170.000 millones de euros. Es necesario implantar protocolos multidisciplinares para el abordaje de la DRE. Objetivo: estudiar la proporción de pacientes afectados o en riesgo de DRE al ingreso, la duración y el coste de su estancia en un hospital general. Métodos: estudio observacional de corte transversal con un tamaño muestral de 203 sujetos. De junio a diciembre de 2018 se realizó un cribado nutricional conforme al Nutritional Risk Screening 2002 (NRS-2002), se hizo un diagnóstico según los criterios de la Iniciativa de Liderazgo Mundial en Desnutrición (GLIM), se registró la duración del ingreso y se efectuó una estimación del coste de la estancia de todos los pacientes que ingresaron en medicina interna y cumplían los criterios de selección. Resultados: la proporción de personas en riesgo de DRE fue del 28 % (57/203; IC 95 %: 22 % a 34 %). La proporción de pacientes con diagnóstico de DRE fue del 19 % (36/192; IC 95 %: 13 % a 24 %). Los pacientes clasificados con riesgo o diagnóstico de DRE al ingreso tuvieron una estancia 3 días mayor que la de los normonutridos (p < 0,01) y un coste mayor que el de los normonutridos en 1.803,66 euros (p < 0,01). Conclusiones: se hace necesario un abordaje integral y multidisciplinar de la DRE coordinada desde la Comunidad, la Atención Primaria y los hospitales, especialmente en las mujeres de ≥ 70 años con patología pulmonar.

Evaluación inicial de un programa de formación continua para auxiliares de ayuda domiciliaria: riesgo nutricional entre los usuarios / Baseline evaluation of a continuing education proram for home delivered care support providers: nutrition risk among users

Introducción: Se diseñó un programa de formación continua dirigido a auxiliares de ayuda domiciliaria para aumentar la concienciación y motivación sobre la importancia de los cuidados alimentarios y nutricionales en el bienestar de los usuarios. En este trabajo se presentan resultados de la evaluación inicial sobre riesgo nutricional en usuarios de ayuda domiciliaria pública en Bilbao. Métodos: Se diseñó un programa multidisciplinar de formación continua con una duración de 20 horas. Se realizó un estudio transversal de evaluación inicial considerando factores determinantes de riesgo nutricional, hábitos alimentarios y actividad física de los clientes. Se aplicó el test abreviado de cribado validado del Mini Nutritional Assessment (MNA), un test de cribado para pacientes en la comunidad y el DETERMINE. Resultados: en la primera fase del proyecto participaron 75 personas que prestan servicio en dos distritos diferentes de la ciudad a 600 clientes. En el estudio previo participaron 218 usuarios con edad media 76,89 años en hombres y 81,19 años en mujeres. Los principales factores de riesgo nutricional identificados fueron consumir más de tres fármacos diarios, comer solos y limitaciones para la compra, preparación y consumo de alimentos y bebidas. El 63% obtenía puntuaciones de riesgo según el cribado MNA. Conclusión: La prevalencia de riesgo de malnutrición es elevada entre los usuarios del servicio de ayuda a domicilio en la ciudad. La sensibilización y entrenamiento adecuado de los cuidadores es esencial para proporcionar un servicio de cuidados de alta calidad (AU)

Background and objectives: A continuing education program for workers in the public home delivered support care service was designed with the aim of increasing awareness and motivation about the relevance of food and nutrition care for the wellbeing of the clients of the service. In this paper results of baseline evaluation regarding nutritional risk of users of the service are presented. Methods: A 20 hour multidisciplinary education program was designed. As part of the evaluation, a protocol for baseline assessment was designed including determinants factors of nutrition risk, food habits and physical activity of clients and screening using the validated short version of the Mini Nutritional Assessmen (MNA) a screening tool for community dweling patients and DETERMINE screener. Results: In the first hase of the project 75 people providing care in two city districts were involved. About 600 clients receive care in these districts. Data were collected for 218 users. Mean age of client was 76.89yr for men and 81.19 yr for women. Key determimnants factors of nutrition risk identified in the group were consuming more than 3 drugs daily, eating alone and limitations for buying, preparing or consuming food and beberages. According to MNA screening, 63% scored at risk of malnutrition. Conclusion: Prevalence of risk of malnutritions is high among home delivered support care. Awareness and adequate training for care providers should be essential for a high quality service (AU)