Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study

Abstract

Objective: We determined the nutrition status and prevalence of malnutrition as determined by the Subjective Global Assessment in Latin America, investigated the awareness of the health team with regard to nutrition status, evaluated the use of nutritional therapy, and assessed the governmental policies regulating the practice of nutritional therapy in each country.

Methods: This cross-sectional, multicenter epidemiologic study enrolled 9348 hospitalized patients older than 18 y in Latin America. Student's t test and chi-square tests were used to analyze univariate analysis and multiple logistic regression analysis, respectively.

Results: Malnutrition was present in 50.2% of the patients studied. Severe malnutrition was present in 11.2% of the entire group. Malnutrition correlated with age (>60 y), presence of cancer and infection, and longer length of hospital stay (P < 0.05). Fewer than 23% of the patients' records contained information on nutrition-related issues. Nutritional therapy was used in 8.8% of patients (6.3% enteral nutrition and 2.5% parenteral nutrition). Governmental policies ruling the practice of nutritional therapy exist only in Brazil and Costa Rica.

Conclusions: Hospital malnutrition in Latin America is highly prevalent. Despite this prevalence, physicians' awareness of malnutrition is weak, nutritional therapy is not used routinely, and governmental policies for nutritional therapy are scarce.