Hospital malnutrition in gastro-entero-hepatology (GEH) patients and its relationship to clinical outcomes: a retrospective cohort study.

Autores/as

  • Maya Rosmaria Puspita Maya Department of Nutrition, Hasanuddin University
  • Aminuddin Aminuddin Clinical Nutrition Specialist Program, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
  • Nurpudji A. Taslim Clinical Nutrition Specialist Program, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia

DOI:

https://doi.org/10.12873/451maya

Palabras clave:

Malnutrition, Gastro-entero- hepatology, Hospitalization, Nutritional Support, Inflammatory Markers

Resumen

Background: Hospital malnutrition remains a significant global health burden, particularly among gastro-entero-hepatology patients. It adversely impacts clinical outcomes, prolongs hospital stays, and raises healthcare costs. Despite its relevance, recent data on malnutrition among Indonesia’s gastro-entero-hepatology (GEH) patients are limited.

Objective: To determine the prevalence of malnutrition and its associated risk factors and clinical outcomes, inflammatory markers, and Prognostic Nutritional Index (PNI) in GEH patients at Wahidin Sudirohusodo General Hospital.

Methods: A retrospective cohort study was conducted among 569 GEH inpatients aged 18–59 years with hospital stays exceeding 7 days. Nutritional risk was assessed using the Malnutrition Screening Tool (MST), while Neutrophil-Lymphocyte Ratio (NLR), Total Lymphocyte Count (TLC), and Prognostic Nutritional Index (PNI) were measured as inflammatory markers. Statistical analyses evaluated correlations between malnutrition risk, clinical outcomes, and laboratory values.

Results: Of the 569 patients, 7.4% were at high risk of malnutrition, 38.7% at moderate risk, and 54% at low risk. High-risk patients showed significantly elevated NLR (p = 0.000) and lower TLC (p = 0.000), reflecting an impaired immune response. These patients also had a lower PNI (p = 0.000) and more extended hospital stays (p = 0.000). No significant difference in mortality was found between different malnutrition risk groups.

Conclusion: Malnutrition is prevalent among GEH patients, particularly those with malignancies. Early nutritional screening and appropriate interventions are essential to improving clinical outcomes and reducing hospital stay durations. A multidisciplinary approach is necessary to optimize patient care.

Citas

Bellanti F, Lo Buglio A, Quiete S, Vendemiale G. Malnutrition in hospitalized old patients: screening and diagnosis, clinical outcomes, and management. Nutrients. 2022;14(4):910.

Menteri Kesehatan Republik Indonesia. Pedoman Nasional Pelayanan Kedokteran Tatalaksana Malnutrisi Dewasa [Internet]. 2019 [cited 2024 Sep 16]. Available from: https://yankes.kemkes.go.id/unduhan/fileunduhan_1610416412_498969.pdf

Reber E, Gomes F, Vasiloglou MF, Schuetz P, Stanga Z. Nutritional risk screening and assessment. J Clin Med. 2019;8(7):1065.

Cass AR, Charlton KE. Prevalence of hospital‐acquired malnutrition and modifiable determinants of nutritional deterioration during inpatient admissions: A systematic review of the evidence. Journal of Human Nutrition and Dietetics. 2022;35(6):1043–58.

Langley-Evans SC. Nutrition screening tools: still no consensus 40 years on. Vol. 34, Journal of human nutrition and dietetics: the official journal of the British Dietetic Association. 2021. p. 923–5.

Ringel JB, Jannat-Khah D, Chambers R, Russo E, Merriman L, Gupta R. Impact of gaps in care for malnourished patients on length of stay and hospital readmission. BMC Health Serv Res. 2019;19:1–6.

Norman K, Kirchner H, Lochs H, Pirlich M. Malnutrition affects the quality of life in gastroenterology patients. World journal of gastroenterology: WJG. 2006;12(21):3380.

Keller U. Nutritional laboratory markers in malnutrition. J Clin Med. 2019;8(6):775.

Merker M, Felder M, Gueissaz L, Bolliger R, Tribolet P, Kägi-Braun N, et al. Association of baseline inflammation with the effectiveness of nutritional support among patients with disease-related malnutrition: a secondary analysis of a randomized clinical trial. JAMA Netw Open. 2020;3(3):e200663–e200663.

Kaya T, Açıkgöz SB, Yıldırım M, Nalbant A, Altaş AE, Cinemre H. Association between neutrophil‐to‐lymphocyte ratio and nutritional status in geriatric patients. J Clin Lab Anal. 2019;33(1):e22636.

Rocha NP, Fortes RC. Total lymphocyte count and serum albumin as predictors of nutritional risk in surgical patients. ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo). 2015;28(3):193–6.

Marín-Castro AE, Ortiz-Espinel DO, Sánchez-Toro CA, Zapata-Acevedo CM, Marín- Castro MJ, Conde-Rodríguez BD, et al. Relationship of the prognostic nutritional index with complications and mortality in patients with gastric cancer who underwent gastrectomy in a tertiary hospital in Bogotá, Colombia. Revista Colombiana de Cirugía. 2022;37(1):60– 71.

Wu M, Zhu Y, Chen X, Wang X, Lin X, Yan X, et al. The prognostic nutritional index predicts the prognosis of patients with advanced esophageal cancer treated with immune checkpoint inhibitors: a retrospective cohort study. J Gastrointest Oncol. 2023;14(1):54.

Correia MITD, Perman MI, Waitzberg DL. Hospital malnutrition in Latin America: A systematic review. Clinical nutrition. 2017;36(4):958–67.

Beghetto MG, Koglin G, Mello ED de. Influence of the assessment method on the prevalence of hospital malnutrition: a comparison between two periods. Nutricion hospitalaria Madrid Vol 25, no 5 (2010), p 774-780. 2010;

Molas MT, Farré CV, Talaveron JML, Badosa EL, Tahull MB, Casas NV, et al. Hospital malnutrition screening at admission: malnutrition increases mortality and length of stay. Nutr Hosp. 2017;34(4):907–13.

Abrha MW, Seid O, Gebremariam K, Kahsay A, Weldearegay HG. Nutritional status significantly affects hospital length of stay among surgical patients in public hospitals of Northern Ethiopia: single cohort study. BMC Res Notes. 2019;12:1–6.

Barker LA, Gout BS, Crowe TC. Hospital malnutrition: prevalence, identification, and impact on patients and the healthcare system. Int J Environ Res Public Health. 2011;8(2):514–27.

Gomes F, et al. Association of Nutritional Support With Clinical Outcomes Among Medical Inpatients Who Are Malnourished or at Nutritional Risk An Updated Systematic Review and Meta-analysis. 2022.

İğde MH, Oruç Ö, Kocatepe V. The Correlation of Malnutrition with Mortality and Morbidity According to Global Initiative on Malnutrition Criteria in the Palliative Care Unit. Florence Nightingale J Nurs. 2023;31(Suppl 1):7.

Patel J, Bains K, Kalra S, Singh I, Kohli I, Dukovic D, et al. The Effects of Malnutrition on Inpatient Outcomes in Patients With Gastroparesis: A Nationwide Analysis. Cureus. 2023;15(10).

Elia M. Defining, recognizing, and reporting malnutrition. Int J Low Extrem Wounds. 2017;16(4):230–7.

Descargas

Publicado

03-02-2025

Cómo citar

Maya, M. R. P., Aminuddin, A., & Taslim, N. A. (2025). Hospital malnutrition in gastro-entero-hepatology (GEH) patients and its relationship to clinical outcomes: a retrospective cohort study. Nutrición Clínica Y Dietética Hospitalaria, 45(1). https://doi.org/10.12873/451maya

Artículos más leídos del mismo autor/a