scholarly journals Acute Diverticulitis Is at Significant Risk of Malnutrition: an Analysis of Hospitalized Patients in a Medicine Department

2020 ◽  
Vol 28 ◽  
pp. 53-56
Author(s):  
GianMarco Giorgetti ◽  
Federica Fabiocchi ◽  
Giovanni Brandimarte ◽  
Antonio Tursi
Keyword(s):  
Nutritional Status ◽  
Hospital Stay ◽  
Large Scale ◽  
Acute Diverticulitis ◽  
Significant Risk ◽  
Length Of Hospital Stay ◽  
Tertiary Hospital ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Medicine Department

Background and Aim: The Nutritional Risk Security (NRS2002) System is recommended for hospitalized patients in order to assess their nutritional status. However, studies assessing large-scale systematic screening policies are lacking. The aim of this study was to assess the feasibility of implementing a screening strategy concerning all admissions for diverticular disease (DD) of the colon in the Department of Medicine of a Tertiary Hospital. Methods: All patients suffering from acute diverticulitis (AD) and admitted to the Medicine Department from January 1st to 31 December 2017, were pre-screened by NRS2002 System by the nursing staff of the Nutritional team at the day of the admission. If the pre-screening was positive, the patients were referred to a supplementary assessment performed by a dietician. Results: The global number of admissions in the observational period was 4,667 and 133 patients suffered from AD. A positive pre-screening test was recorded in 97 (72.9%) patients: a NRS2002 score > 3, describing a severe impaired nutritional status was found in 61 patients (62.9%). All 97 patients with a NRS2002 positive screening received initial nutritional support by oral supplements (17 patients, 17.52%) or enteral nutrition (22 patients, 22.68%) or total parenteral nutrition (58 patients, 59.8%). The mean length of hospital stay for all 133 patients was 6,9 days. However, the length of hospital stay was significantly longer for patients with a positive NRS2002, with a mean of 18 days (p= 0.01) Conclusions: A large number of hospitalized patients due to AD are at nutritional risk and have a significantly longer hospital stay.

scholarly journals Dietary considerations for the sick and hospitalized patients

2017 ◽  
Vol 13 (1) ◽  
pp. 101-107
Author(s):  
Shilpi Kumari ◽  
M Vikram
Keyword(s):  
Nutritional Status ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Hospitalized Patients ◽  
Nutritional Requirement ◽  
Clinical Perspective ◽  
Important Impact ◽  
Disease Condition ◽  
Hospitalized Patient ◽  
Underlying Diseases

From a clinical perspective, knowledge of the nutritional status of a hospitalized patient is an indispensable strategy for establishing an adequate approach to the maintenance and/or recovery of nutritional status during the hospital stay. Nutritional status has an important impact on the course of underlying diseases. Malnutrition increases the rate of morbidity, length of hospital stay and certain other complications. Therefore malnutrition becomes very common among hospitalized patients which in turn lead to morbidity and increased hospital stay. Nutritional requirement of the patient vary in different disease condition and their mode of feeding depends upon the condition of the patient and the functioning organ Health Renaissance 2015;13 (1): 

scholarly journals Patient-Generated Subjective Global Assessment (PG-SGA) predict Length of hospital stay in lung adenocarcinoma patients

2021 ◽  
pp. 1-20
Author(s):  
Jilu Lang ◽  
Yanan Shao ◽  
Jiehao Liao ◽  
Jia Chen ◽  
Xuewen Zhou ◽  
...  
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Lung Adenocarcinoma ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Northern China ◽  
Nutritional Risk ◽  
Chinese Patients ◽  
Nrs 2002 ◽  
Northern Chinese

The prevalence of malnutrition is high among oncology patients in Northern China. Malnutrition is related to the longer hospital stay, and it can be used to predict the prognostic outcome of patients. This work focused on investigating the relationship of nutritional condition with the length of hospital stay (LOS) in Northern Chinese patients with lung adenocarcinoma. The PG-SGA, Nutritional Risk Screening 2002 (NRS 2002) score, recent weight loss and BMI were assessed in a probabilistic sample of 389 lung adenocarcinoma patients without EGFR mutations. This study collected the demographic and clinical features of patients in a prospective manner. Then, we examined the association of nutritional status with LOS among the population developing lung adenocarcinoma. According to the PG-SGA, 63 (16.3%), 174 (44.7%) and 78 (20.1%) patients were at risk for undernutrition, moderate undernutrition and severe undernutrition, respectively. Nutritional risk was found in 141 (36.2%) patients based on the NRS 2002. The average LOS for tumor patients in Northern China was 12.5 days. At admission, a risk of undernutrition or undernutrition according to the PG-SGA (P<0.001), NRS 2002 (P<0.001), and latest weight loss (P<0.001) predicted the longer LOS. Length of stay was related to nutritional status and hospitalization expenses (P<0.001). Lung adenocarcinoma patients who stayed in the ICU had a poorer nutritional status and a longer LOS (P<0.001). In Northern Chinese patients with lung adenocarcinoma, a risk for undernutrition evaluated by the PG-SGA, the NRS2002 and recent weight loss, but not BMI, could predict a longer LOS.

scholarly journals Palliative treatment for malignant gastrointestinal obstruction with peritoneal carcinomatosis: enteral stenting versus surgery

2020 ◽  
Vol 08 (10) ◽  
pp. E1487-E1494
Author(s):  
Veeravich Jaruvongvanich ◽  
FNU Chesta ◽  
Anushka Baruah ◽  
Meher Oberoi ◽  
Daniel Adamo ◽  
...  
Keyword(s):  
Adverse Events ◽  
Hospital Stay ◽  
Peritoneal Carcinomatosis ◽  
Large Scale ◽  
Clinical Success ◽  
Eastern Cooperative Oncology Group ◽  
Length Of Hospital Stay ◽  
Palliative Surgery ◽  
Gastrointestinal Obstruction ◽  
Malignant Gastrointestinal Obstruction

Abstract Background and study aims Management of malignant gastrointestinal obstruction (MGIO) is more challenging in the presence of peritoneal carcinomatosis (PC). Outcomes data to guide the management of MGIO with PC are lacking. We aimed to compare the clinical outcomes and adverse events between endoscopic and surgical palliation and identify predictors of stent success in patients with MGIO with PC. Patients and methods Consecutive inpatients with MGIO with PC between 2000 and 2018 who underwent palliative surgery or enteral stenting were included. Clinical success was defined as relief of obstructive symptoms. Results Fifty-seven patients with enteral stenting and 40 with palliative surgery were compared. The two groups did not differ in rates of technical success, 30-day mortality, or recurrence. Clinical success from a single intervention (63.2 % versus 95 %), luminal patency duration (27 days vs. 145 days), and survival length (148 days vs. 336 days) favored palliative surgery (all P < 0.05) but the patients in the surgery group had a trend toward better Eastern Cooperative Oncology Group (ECOG) status. The rate of adverse events (AEs) (10.5 % vs. 50 %), the severity of AEs, and length of hospital stay (4.5 days vs. 9 days) favored enteral stenting (P < 0.05). The need for more than one stent was associated with a higher likelihood of stent failure. Conclusions Our study suggests that enteral stenting is safer and associated with a shorter hospital stay than palliative surgery, although unlike other MGIOs, clinical success is lower in MGIO with PC. Identification of the right candidates and potential predictors of clinical success in ECOG-matched large-scale studies is needed to validate these results.

scholarly journals 1464. Adjuvant Systemic Steroid Therapy and Length of Hospital Stay in Pneumonia Patients: A Retrospective Cohort Study in a Community Hospital

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S733-S734
Author(s):  
Rattanaporn Mahatanan
Keyword(s):  
Hospital Stay ◽  
Steroid Therapy ◽  
Subgroup Analysis ◽  
Community Hospital ◽  
Length Of Hospital Stay ◽  
Hospitalized Patients ◽  
Systemic Steroid ◽  
Inpatient Mortality ◽  
Copd Patients ◽  
Class Iv

Abstract Background Pneumonia is a leading cause of morbidity and mortality worldwide resulting in a substantial healthcare expenditure. Antimicrobial agents are the main treatment. Recent studies showed the benefits of steroid therapy as an adjuvant therapy for patients with pneumonia; however, the overall evidence is still controversial. Methods Electronic medical records of hospitalized patients (age &gt;18) at a community hospital in a rural Maine with the discharge diagnosis of pneumonia in 2015 and 2016 were reviewed. Demographics, comorbidities, physical examination, initial laboratory, and Pneumonia Severity Index (PSI) were collected for each patient. The exposure was a systemic steroid administered by either oral or intravenous. The outcomes included length of hospital stay (LOS), inpatient mortality, and transfer to tertiary care center. Competing-risks regression was utilized to examine the association between steroid and LOS. Multivariable logistic regression analysis adjusted for propensity score was used for other outcomes. Results A total of 414 patients were included. 277(63%) patients received systemic steroids. Overall, steroid use was significantly associated with shorter LOS (HR 1.26, 95%CI 1.03-1.54, p=0.02) and decrease inpatient mortality (OR 0.11, 95%CI 0.03-0.45, p&lt; 0.01). In subgroup analysis, steroid associated with shorter LOS only in patients with PSI class IV (HR 1.38, 95%CI 1.02-1.89, p=0.04) and PSI class V (HR 2.04, 95%CI 1.11-3.74, p=0.02). There was an association of steroid and shorter LOS in subgroup of COPD patients (HR 1.42, 95%CI 1.02-1.97, p=0.03). Table 1: The baseline characteristics of hospitalized patients with a diagnosis of pneumonia who received steroid vs non-steroid Figure 1: Subgroup analysis the effect of steroid and lenght of hospital stay (LOS) Conclusion Our study concluded that adjuvant steroid therapy associated with a decrease in length of hospital stay and improved inpatient mortality in hospitalized pneumonia patients. Steroid was most beneficial to those with severe pneumonia (PSI class IV-V) and COPD patients. Disclosures All Authors: No reported disclosures

scholarly journals Recognising anaemia and malnutrition in vascular patients with critical limb ischaemia

2010 ◽  
Vol 92 (6) ◽  
pp. 495-498 ◽  
Author(s):  
M Shah ◽  
A Martin ◽  
B Myers ◽  
S MacSweeney ◽  
T Richards
Keyword(s):  
Nutritional Status ◽  
Hospital Stay ◽  
Nutritional Assessment ◽  
Length Of Hospital Stay ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Patient Demographics ◽  
Laboratory Markers ◽  
Bed Days ◽  
Poor Nutrition

INTRODUCTION Anaemia is a common problem in surgical patients. Patients with critical limb ischaemia (CLI) suffer chronic inflammation, repeated infection, require intervention, and can have a protracted hospital stay. The aims of this study were to assess anaemia and nutritional status in patients presenting with CLI. PATIENTS AND METHODS Two observational studies were undertaken, initially a retrospective series of 27 patients with CLI. Patient demographics, clinical details, transfusion status and in-patient laboratory haemoglobin values (Hb) were recorded. In a prospective series of 32 patients, laboratory markers to identify the cause for anaemia were assessed. Further nutritional status was assessed by records of height, weight, body mass index and a validated scoring system. RESULTS In the retrospective series, 15 patients (56%) were anaemic. Ten (37%) were transfused a median of 2 units (range, 2–13), a total of 35 units. Patients who were transfused had lower Hb on admission (P = 0.0019), most were anaemic on admission (90%). At discharge, most patients were anaemic (n = 23; 83%). In the prospective series of 32 patients, 20 (63%) were anaemic. Nutritional assessment was performed on 18, only seven patients were scored undernourished. This was increased to 23 by an independent assessor. Anaemia was associated with malnutrition (n = 17; P = 0.049) and an increased hospital stay (mean 25 days [SD 16] vs mean 12 days [SD 8], P = 0.0125; total 513 vs 144 bed days). CONCLUSIONS Anaemia and poor nutrition are common and not recognised in vascular patients presenting with critical limb ischaemia. Anaemia is associated with and increased length of hospital stay.

scholarly journals A study of nutritional status, development of malnutrition and food consumption in hospitalized patients

2019 ◽  
Vol 3 (2) ◽  
pp. 66-80
Author(s):  
Anil Evrim Gungor ◽  
Perihan Arslan ◽  
Osman Abbasoglu
Keyword(s):  
Weight Loss ◽  
Nutritional Status ◽  
Hospitalized Patients ◽  
Nutritional Risk ◽  
Food Services ◽  
Hospital Malnutrition ◽  
Arm Circumference ◽  
Nrs 2002 ◽  
Mid Upper Arm Circumference ◽  
Nutritional Risk Screening

Purpose: To investigate the nutritional status of patients on admission and during hospital stay, the factors leading to weight loss, and to evaluate patient satisfaction of hospital food. Methods: On admission, Nutritional Risk Screening (NRS-2002), weight, height, Body Mass Index (BMI), mid upper arm circumference (MAC) measurements were carried out; serum total protein and albumin levels were recorded. Upon discharge, measurements of weight, MAC were repeated, along with a food satisfaction questionnaire. Results: Patients with NRS-2002>3, BMI<20, were classified as nutrionally at risk which were 43.6% and 9.4% respectively. Of the patients, 77% lost weight (2.6±1.9 kg). Patients who were determined to be malnourished on admission by BMI and NRS-2002 stayed longer in hospital (p<0.0 and p<0.001, respectively). The relationships between weight loss and lenght of stay, use of medications and period of starvation were significant (p<0.0001, for each). Of the patients, 49.9% did not satisfy with the hospital food. Conclusions: Nutritional status of hospitalized patients should be screened with NRS-2002, assessed and monitored. Keywords: NRS-2002, hospital malnutrition, hospital food services

scholarly journals Role of early enteral feeding in mild and moderate acute pancreatitis

2021 ◽  
Vol 8 (11) ◽  
pp. 3387
Author(s):  
Aswin George Roy ◽  
Haridas T. V.
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Stay ◽  
Enteral Feeding ◽  
Significant Risk ◽  
Length Of Hospital Stay ◽  
Advantages And Disadvantages ◽  
Early Enteral Feeding ◽  
Systemic Complication ◽  
Infective Complications

Background: Timing of enteral feeding in acute pancreatitis was always a matter of controversy. Increasing evidence suggests that early enteral feeding reduces systemic and local complications of pancreatitis and thereby hospital stay. Hence the study has been undertaken to determine the feasibility, advantages and disadvantages of early enteral feeding in mild and moderate acute pancreatitis. Methods: Patients admitted with symptoms and signs suggestive of mild and moderate acute pancreatitis who were started on early enteral feeding (within 48 hours of admission) were included in study. Blood investigation results are used to classify patients accordingly to mild and moderate acute pancreatitis based on Ransons’s score. Patients were followed up and categorized based on development of complications, length of hospital stay.Results: Majority of the patients who were started on early enteral feeding showed significant decrease in complications and hospital stay. Study also suggested that age is a significant risk in development of complications. Gender is not significant in the development of complications.Conclusions: There is significant decrease in rate of systemic complication, local infective and non-infective complications, length of hospital stay among acute pancreatitis patients who were started on early enteral feeding (within 48 hours).

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