A Prospective Study on Malnutrition and Duration of Hospitalisation among Hospitalised Geriatric Patients Admitted to Surgical and Medical Wards of Hospital Universiti Kebangsaan Malaysia

Abstract

Elderly people are known to be at a greater risk of malnutrition, particularly those having diseases or illnesses. A prospective study was undertaken on 92 hospitalised geriatric patients (45.6% males), aged 60 to 89 years old, admitted to surgical and medical wards at Hospital Universiti Kebangsaan Malaysia (HUKM). The study aimed to assess malnutrition at admission, day 3 and day 7 of hospitalisation, and its relation with length of stay in the wards. Malnutrition was assessed using anthropometrics and biochemical indicators. Although the majority of subjects had a normal Body Mass Index (BMI), 10.9% had Chronic Energy Deficiency (CED) and 38% were overweight. A total of 10% subjects had muscle wasting as assessed by Mid-upper Arm Circumference (MUAC). Biochemical tests indicated that women subjects were more likely to have hypoalbuminaemia (p <0.05) whilst, men were at risk of anaemia (p < 0.05). Throughout hospitalisation, there was a significant reduction in body weight, biceps skinfold thickness, calf circumference, MUAC, percentage of body fat and body mass index (BMI) in both males and females (p < 0.05 for all parameters). Biochemical tests on a sub sample of subjects indicated that 71.4% had hypoalbuminaemia and 39.6% were anaemic. Subjects diagnosed with cancer, had loss of appetite or had poor nutritional status as assessed by BMI or MUAC on admission were more likely to be hospitalised longer than or equal to 7 days (p < 0.05 for all parameters). Serum albumin levels at admission correlated positively with MUAC values both on admission (r = 0.608, p <0.01) and at clay seven of hospitalisation (r = 0.906, p < 0.05). There is a need to screen elderly patients at high risk of malnutrition at admission in order to reduce the length of stay and increase their health and nutritional status.