NUTRITIONAL STATUS IN HOSPITALIZED PATIENTS: RESULTS OF NATIONAL SURVEY FOR NUTRITIONAL ASSESSMENT IN IRANIAN HOSPITALS.

Disease-related malnutrition is a highly prevalent condition in health care settings. Malnutrition is main nutritional concern in hospitals. Malnutrition causes prolonged hospital stay, increased risk of infection, delayed wound healing, mechanical ventilation dependency and increased mortality and morbidity in patients. Nutritional screening is the first step in commencing medical nutrition therapy in hospitals. By identifying malnourished patients or patients in high risk of malnutrition, nutritional support team will be able to pursue and plan proper nutritional treatment.Malnutrition in different hospital setting varies. In two nationwide studies, prevalence of malnutrition in Iranian hospitals in general medical and surgical wards and also in intensive care units has been evaluated. In a nationwide study a total of 2306 patients were evaluated for malnutrition in 20 Iranian general hospitals. Mean values of age and body mass index were 44.7±14 years and 25/2±6 kg/m2, respectively. Malnutrition was identified in 23.9% of the patients, 26.2% and 21% of whom were among the admitted and discharged patients, respectively (SGA score). The prevalence of malnutrition was higher in burns (78%) and heart surgery (58%) patients. This value in tertiary and referral hospitals is around 38%.In a comprehensive study in 25 Iranian intensive care units the prevalence of patients in risk of moderate and severe malnutrition was 42% of patients (modified nutric score, number of patients: 1321). In this study, it was shown that 62% of patients suffer from inadequate energy intake and this number for protein insufficient intake in ICU patients is 60% of calculated protein requirement. In ICUs the prevalence of malnutrition was highest in thorax/lung and oncology ICUs (48% and 42% respectively).One out of four patients in the Iranian general hospitals and 42% of patients hospitalized in ICUs were suffering from malnutrition. Appropriate measures should be taken to ameliorate this condition. In nationwide medical nutrition therapy it is important for adopting a comprehensive approach to tackle and treat malnourished patients.

Keywords:

malnutrition , medical nutrition therapy , nutric score , SGA score , nutrition support team