Léon G. Blaise Savadogo^1,2, Seydou Traoré², Clément Z. Meda^1,2, Joseph Bamouni²

Show more
¹ Department of Epidemiology and Public Health, Child and Mother Health, Nutrition and Survival Unit, Institut Supérieur des Sciences de la Santé, Bobo Dioulasso, Burkina Faso.
² CHUSS (University Hospital of Bobo Dioulasso), Bobo-Dioulasso, Burkina Faso.
Show less

Abstract: Background: Despite numerous advances in medicine and clinical care, in developing countries, adult undernutrition is overlooked and not considered as a sufficient medical priority. The objective of this study was to identify the magnitude of adult undernutrition and its associated factors in hospitalized patients. Methods: Cross-sectional study, performed in the university hospital in Bobo-Dioulasso, from August to September 2016, in a sample of 244 adult individuals. Patients were included in the study consecutively to their admission. A structured questionnaire was applied consisting of anthropometric, clinical and dietary data. The patients were evaluated and dichotomized into undernourished and non-undernourished. The rate of undernutrtion was reported using and associated factors were tested using the unadjusted crude Odds ratios (COR) with 95% confidence interval (95% CI) and the Chi-square test. Results: Undernutrition occurred in 32.4% of the sample and at the univariate analysis, the variables associated with undernutrition were: recent and involuntary weight loss (COR = 2.58, 95% CI = 1.45 - 4.59, p < 0.001); disease chronic evolution (COR = 2.29, 95% CI = 1.23 - 4.23, p = 0.008) and females (COR = 1.76, 95% CI = 1.02 - 6.06, p = 0.04). Conclusion: Adult undernutrition is common in hospitalized patients. A proper early diagnosis and therapy need to be considered as medical priority of the entire healthcare team that treats adult’s inpatients.

Keywords: Adult, Undernutrition, Inpatients

Cite this paper: Savadogo, L. , Traoré, S. , Meda, C. and Bamouni, J. (2019) Undernutrition in Adults Hospitalized Patients: Magnitude and Associated Factors at the University Hospital of Bobo-Dioulasso. Open Journal of Epidemiology, 9, 27-35. doi: 10.4236/ojepi.2019.91003.

References

[1]   Bistran, B.R., Blackburn, G.L., Vitale, J., Cochran, D. and Naylor, J. (1976) Prevalence of Malnutrition in General Patients. JAMA, 233, 1567-1570.
https://doi.org/10.1001/jama.1976.03260410023017

[2]   Kamath, S.K., Lawler, M., Smith, A.E. and Olson, R. (1986) Hospital Malnutrition: A 33-Hospital Screening Study. Journal of the American Dietetic Association, 86, 203-206.

[3]   Coats, K.G., Morgan, S.L., Bartolucci, A.A. and Weinsier, R.L. (1993) Hospital Associated Malnutrition: A Reevaluation Twelve Years Later. Journal of the American Dietetic Association, 93, 27-33.
https://doi.org/10.1016/0002-8223(93)92126-I

[4]   Waitzberg, D.L., Caiaffa, W.T. and Correia, M.I.T.D. (2001) Hospital Malnutrition: The Brazilian National Survey (IBRANUTRI): A Study of 4000 Patients. Nutrition, 17, 573-580.
https://doi.org/10.1016/S0899-9007(01)00573-1

[5]   Correia, M.I.T.D. and Campos, A.C.L. (2003) Prevalence of Hospital Malnutrition in Latin America: The Multicenter ELAN Study. Nutrition, 19, 823-825.
https://doi.org/10.1016/S0899-9007(03)00168-0

[6]   O’Flynn, Peake, H., Hickson, M., Foster, D. and Frost, G. (2005) The Prevalence of Malnutrition in Hospitals Can Be Reduced. Clinical Nutrition, 24, 1078-1088.
https://doi.org/10.1016/j.clnu.2005.08.012

[7]   Sullivan, D.H., Bopp, M.M. and Roberson, P.K. (2002) Protein-Energy Undernutrition and Life-Threatening Complications among the Hospitalized Elderly. Journal of General Internal Medicine, 17, 923-932.
https://doi.org/10.1046/j.1525-1497.2002.10930.x

[8]   Chima, C.S., Barco, K., Dewitt, M.L., Maeda, M., Teran, J.C. and Mullen, K.D. (1997) Relationship of Nutritional Status to Length of Stay, Hospital Costs, and Discharge Status of Patients Hospitalized in the Medicine Service. Journal of the American Dietetic Association, 97, 975-978.
https://doi.org/10.1016/S0002-8223(97)00235-6

[9]   Pichard, C., Kyle, U.G., Morabia, A., et al. (2004) Lean Body Mass Depletion at Hospital Admission Is Associated with an Increased Length of Stay. American Journal of Clinical Nutrition, 79, 613-618.
https://doi.org/10.1093/ajcn/79.4.613

[10]   Kyle, U.G., Schneider, S.M., Pirlich, M., Lochs, H., Hebuterne, X.T. and Pichard, C. (2005) Does Nutritional Risk, as Assessed by Nutritional Risk Index, Increase during Hospital Stay? A Multinational Population-Based Study. Clinical Nutrition, 24, 516-524.
https://doi.org/10.1016/j.clnu.2005.04.003

[11]   Raslan, M., Gonzalez, M.C., Dias, M.C.G., Nascimento, M., Castro, M., Marques, P., et al. (2010) Comparison of Nutritional Risk Screening Tools for Predicting Clinical Outcomes in Hospitalized Patients. Nutrition, 26, 721-726.
https://doi.org/10.1016/j.nut.2009.07.010

[12]   Kondrup, J., Johansen, N., Plum, L.M., Bak, L., Hojlund Larsen, I., Martinsen, A., et al. (2002) Incidence of Nutritional Risk and Causes of Inadequate Nutritional Care in Hospitals. Clinical Nutrition, 21, 461-468.
https://doi.org/10.1054/clnu.2002.0585

[13]   Somanchi, M., Tao, X. and Mullin, G.E. (2011) The Facilitated Early Enteral and Dietary Management Effectiveness Trial in hospitalized Patients with Malnutrition. Journal of Parenteral and Enteral Nutrition, 35, 209-216.
https://doi.org/10.1177/0148607110392234

[14]   Bistrian, B.R., Blackburn, G.L., Hallowell, E. and Heddle, R. (1974) Protein Status of General Surgical Patients. JAMA, 230, 858-860.
https://doi.org/10.1001/jama.1974.03240060028025

[15]   Braunschweig, C., Gomez, S. and Sheean, P.M. (2000) Impact of Declines in Nutritional Status on Outcomes in Adult Patients Hospitalized for More Than 7 Days. Journal of the American Dietetic Association, 100, 1316-1322.
https://doi.org/10.1016/S0002-8223(00)00373-4

[16]   Callahan, C.M. and Wolinsky, F.D. (1996) Hospitalization for Pneumonia among Older Adults. The Journals of Gerontology, 51, M276-M282.
https://doi.org/10.1093/gerona/51A.6.M276

[17]   Sullivan, D.H. (1992) Risk Factors for Early Hospital Readmission in a Select Population of Geriatric Rehabilitation Patients: The Significance of Nutritional Status. Journal of the American Geriatrics Society, 40, 792-798.
https://doi.org/10.1111/j.1532-5415.1992.tb01851.x

[18]   Schneider, S.M., Hebuterne, et al. (2004) Malnutrition Is an Independent Factor Associated with Nosocomial Infections. British Journal of Nutrition, 92, 105-111.
https://doi.org/10.1079/BJN20041152

[19]   Kassin, M.T., Owen, R.M., Perez, S.D., et al. (2012) Risk Factors for 30-Day Hospital Readmission among General Surgery Patients. Journal of the American College of Surgeons, 215, 322-330.
https://doi.org/10.1016/j.jamcollsurg.2012.05.024

[20]   Krumholz, H.M. (2013) Post-Hospital Syndrome—An Acquired, Transient Condition of Generalized Risk. The New England Journal of Medicine, 368, 100-102.
https://doi.org/10.1056/NEJMp1212324

[21]   Kirkland, K.B., Briggs, J.P., Trivette, S.L., Wilkinson, W.E. and Sexton, D.J. (1999) The Impact of Surgical-Site Infections in the 1990s: Attributable Mortality, Excess Length of Hospitalization, and Extra Costs. Infection Control & Hospital Epidemiology, 20, 725-730.
https://doi.org/10.1086/501572

[22]   Elixhauser, A. and Steiner, C. (2013) Readmissions to US Hospitals by Diagnosis, 2010. Healthcare Cost and Utilization Project Statistical Brief #153.
http://www.hcup-us.ahrq.gov/reports/statbriefs/sb153.pdf

[23]   Kubrack, C. and Jensen, L. (2007) Malnutrition in Acute Care Patients. International Journal of Nursing Studies, 44, 1036-1054.
https://doi.org/10.1016/j.ijnurstu.2006.07.015

[24]   Thomas, D.R., Zdrowski, C.D., Wilson, M.M., et al. (2002) Malnutrition in Subacute Care. The American Journal of Clinical Nutrition, 75, 308-313.
https://doi.org/10.1093/ajcn/75.2.308

[25]   Kruizenga, H.M., Tulder, M.W.V., Seidell, J.C., Thijs, A., Ader, H.J. and Van Bokhurst-de van der Schueren, M.A.E. (2005) Effectiveness and Cost-Effectiveness of Early Screening and Treatment of Malnourished Patients. The American Journal of Clinical Nutrition, 82, 1082-1089.
https://doi.org/10.1093/ajcn/82.5.1082

[26]   Kruizenga, H.M., Seidell, J.C., Vet, H.C.W., Wierdsma, N.J. and Van Bokhorstde van der Schueren, M.A.E. (2005) Development and Validation of a Hospital Screening Tool for Malnutrition: The Short Nutritional Assessment Questionnaire. Clinical Nutrition, 24, 75-82.
https://doi.org/10.1016/j.clnu.2004.07.015

[27]   De Cássia De Aquino, R. and Tucunduva Philippi, S. (2011) Identification of Malnutrition Risk Factors in Hospitalized Patients. Revista da Associação Médica Brasileira, 57, 623-629.
https://doi.org/10.1016/S0104-4230(11)70127-0

[28]   Pirlich, M., Schütz, T., Kemps, M., Luhman, N., Minko, N., Lübke, J.H., et al. (2005) Social Risk Factors for Hospital Malnutrition. Nutrition, 21, 295-300.
https://doi.org/10.1016/j.nut.2004.06.023

[29]   Splett, P.L., Roth-Yousey, L.L. and Vogelzang, J.L. (2003) Medical Nutrition Therapy for the Prevention and Treatment of Unintentional Weight Loss in Residential Healthcare Facilities. Journal of the American Dietetic Association, 103, 352-362.
https://doi.org/10.1053/jada.2003.50050