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Review
. 2010 Dec;107(51-52):911-7.
doi: 10.3238/arztebl.2010.0911. Epub 2010 Dec 27.

Malnutrition in hospital: the clinical and economic implications

Christian Löser  1
Affiliations
Review

Malnutrition in hospital: the clinical and economic implications

Christian Löser. Dtsch Arztebl Int. 2010 Dec.

Abstract

Background: Undernutrition and malnutrition are common in hospitalized patients. Their combined prevalence on admission is estimated at 25% and is rising.

Methods: Selective literature review with special consideration of current guidelines and meta-analyses.

Results: The nutritional state of every patient should be assessed on admission with simple, established parameters, and patients suffering from under- or malnutrition should be treated with a targeted nutritional intervention based on the established stepwise treatment algorithm. Under- and malnutrition are an independent risk and cost factor with a significant influence on mortality, morbidity, length of hospital stay, and quality of life. Their direct costs alone amount to some 9 billion Euros in Germany each year. Therapeutic trials and meta-analyses have clearly documented the therapeutic benefit and cost-effectiveness of oral nutritional supplements and tube feeds. Targeted nutritional intervention is an integral part of medical treatment and prevention.

Conclusion: Undernutrition and malnutrition are common in hospitalized patients and are both medically and economically harmful. If they are detected early by targeted assessment and then treated appropriately according to the established stepwise treatment algorithm, better clinical outcomes and lower costs will result.

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Figures

Figure 1
Figure 1
Extent of deterioration in nutritional status during hospital stay: conclusions of large published studies within the specializations internal medicine and surgery (modified according to R.J. Stratton et al. [4])
Figure 2
Figure 2
Systematic assessment and treatment strategies using nutritional medicine for under-/malnourished patients (modified according to current guidelines [–19])
Figure 3
Figure 3
Changes in body weight in all patients (n = 210) and separately for patients with benign and malignant underlying diseases retrospectively for three months before and prospectively twelve months after a PEG tube is fitted (20)
See this image and copyright information in PMC

Comment in

References

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