Desnutrición Hospitalaria: La experiencia del Hospital "Hermanos Ameijeiras"

Abstract

Rationale: In the last years of the past century and millennium the notion that Energy-Nutrient Malnutrition (ENM) increases morbidity, mortality, length of stay and costs in health centers was finally acepted. It was also demonstrated that the patient’s nutritional status deteriorates during hospitalization. Description: A prospective study was conduced at the Hermanos Ameijeiras Hospital (Havana City, Cuba) in order to estimate the frequency of ENM. The study was included within the Branch Research Program on Health Services. Aim: To estimate the frequency of ENM, as part of a national, multicenter Project. Design: To survey 409 randomized selected patients. The study was conduced in two steps. First step: An audit of the patient’s clinical record. Second step: nutritional assessment by means of the Subjective Global Assessment tool. The survey was conduced by a properly trained and educated work team. Results: 149 patients (35,9%; CI 95 %: 31,3 – 40,6) were classified as malnourished. 13,4% of the patients were considered as severely malnourished. High nutritional risk areas were identified as those with a ENM estimated frequency above the established epidemiological channel: Critical Care (60,0 %), Nephrology (53,3%), Internal Medicine (46,0%), Geriatrics (44,4 %), Cardiovascular Surgery (42,9%), Gastroenterology
(41,2%) and General Surgery (41,2 %). The probability of receiving a malnutrition score increased with prolonged hospitalization time.Conclusions: ENM is a highly prevalent disease in our hospital. This study calls for the need to create a nutritional support group who will be in charge of the design and implementation of an intervention program, which would be
oriented to minimize the deletereal effects of ENM in our center.