Prevalence of Nutritional Risk at Admission in Internal Medicine Wards in Portugal: The Multicentre Cross-Sectional ANUMEDI Study

Authors

  • Ricardo Marinho Co-primeiro autor. Serviço de Medicina Interna. Centro Hospitalar Universitário do Porto. Porto. https://orcid.org/0000-0001-7091-3911
  • Ana Pessoa Co-primeiro autor. Serviço de Medicina Interna. Centro Hospitalar Médio Ave. Vila Nova de Famalicão. https://orcid.org/0000-0002-6881-1657
  • Marta Lopes Serviço de Hematologia Clínica. Centro Hospitalar Universitário do Porto. Porto. https://orcid.org/0000-0003-0306-4731
  • João Rosinhas Serviço de Medicina Interna. Unidade Local de Saúde de Matosinhos. Matosinhos.
  • João Pinho Unidade de Nutrição. Centro Hospitalar Médio Ave. Vila Nova de Famalicão. https://orcid.org/0000-0002-3047-2848
  • Joana Silveira Escola Superior de Biotecnologia. Universidade Católica Portuguesa. Porto.
  • Ana Amado EEIG Ecotrophelia Europe. Avignon.
  • Sandra Silva Independent Researcher. Porto.
  • Bruno Oliveira Faculdade de Ciências de Nutrição e Alimentação. Universidade do Porto. Porto. Laboratório de Inteligência Artificial e Apoio à Decisão. Instituto de Engenharia de Sistemas e Computadores, Tecnologia e Ciência. Porto.
  • Anibal Marinho Unidade de Cuidados Intensivos. Centro Hospitalar Universitário do Porto. Porto. https://orcid.org/0000-0002-9160-8649
  • Harriët Jager-Wittenaar Research Group Healthy Ageing, Allied Health Care and Nursing. Hanze University of Applied Sciences. Groningen. The Netherlands. Department of Oral and Maxillofacial Surgery. University of Groningen. University Medical Center Groningen. Groningen. The Netherlands. https://orcid.org/0000-0003-3928-8075

DOI:

https://doi.org/10.20344/amp.13182

Keywords:

Hospitalization, Internal Medicine, Malnutrition, Nutritional Assessment

Abstract

Introduction: Disease-related undernutrition is highly prevalent and requires timely intervention. However, identifying undernutrition often relies on physician judgment. As Internal Medicine wards are the backbone of the hospital setting, insight into the prevalence of nutritional risk in this population is essential. We aimed to determine the prevalence of nutritional risk in Internal Medicine wards, to identify its correlates, and to assess the agreement between the physicians’ impression of nutritional risk and evaluation by Nutritional Risk Screening 2002.
Material and Methods: A cross-sectional multicentre study was performed in Internal Medicine wards of 24 Portuguese hospitals during 2017. Data on demographics, previous hospital admissions, primary diagnosis, and Charlson comorbidity index score were collected. Nutritional risk at admission was assessed using Nutritional Risk Screening 2002. Agreement between physicians’ impression of nutritional risk and Nutritional Risk Screening 2002 was tested by Cohen’s kappa.
Results: The study included 729 participants (mean age 74 ± 14.6 years, 51% male). The main reason for admission was respiratory disease. Mean Charlson comorbidity index score was 5.8 ± 2.8. Prevalence of nutritional risk was 51%. Nutritional risk was associated with admission during the previous year (odds ratio = 1.65, 95% confidence interval: 1.22 - 2.24), solid tumour with metastasis (odds ratio = 4.73, 95% confidence interval: 2.06 - 10.87), any tumour without metastasis (odds ratio = 2.04, 95% confidence interval:1.24 - 3.34), kidney disease (odds ratio = 1.83, 95% confidence interval: 1.21 - 2.75), peptic ulcer (odds ratio = 2.17, 95% confidence interval: 1.10 - 4.25), heart failure (odds ratio = 1.51, 95% confidence interval: 1.11 - 2.04), dementia (odds ratio = 3.02, 95% confidence interval: 1.96 - 4.64), and cerebrovascular disease (odds ratio = 1.62, 95% confidence interval: 1.12 - 2.35). Agreement between physicians’ evaluation of nutritional status and Nutritional Risk Screening 2002 was weak (Cohen’s kappa = 0.415, p < 0.001).
Discussion: Prevalence of nutritional risk in the Internal Medicine population is very high. Admission during the previous year and multiple comorbidities increase the odds of being at-risk. Subjective physician evaluation is not appropriate for nutritional screening.
Conclusion: The high prevalence of at-risk patients and poor subjective physician evaluation suggest the need to implement mandatory nutritional screening.

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Author Biography

Ricardo Marinho, Co-primeiro autor. Serviço de Medicina Interna. Centro Hospitalar Universitário do Porto. Porto.

Internal Medicine Department

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Published

2021-06-01

How to Cite

1.
Marinho R, Pessoa A, Lopes M, Rosinhas J, Pinho J, Silveira J, Amado A, Silva S, Oliveira B, Marinho A, Jager-Wittenaar H. Prevalence of Nutritional Risk at Admission in Internal Medicine Wards in Portugal: The Multicentre Cross-Sectional ANUMEDI Study. Acta Med Port [Internet]. 2021 Jun. 1 [cited 2024 May 18];34(6):420-7. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/13182

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Original