Authors (including presenting author) :
Chan YLJ, Chan YTT, Chu HKO, Ng WBG
Affiliation :
Department of Dietetics, YCH
Introduction :
Malnutrition has been found in approximately 19-60% of hospitalized patients. Decades of research have shown that malnutrition of patients is related to prolonged illnesses and increased risk of morbidity/mortality. Thus, early screening of hospitalized patients at risk of malnutrition is of paramount importance. Identification of malnutrition risk is the first step to start timely and tailor-made nutritional interventions.
The Malnutrition Universal Screening Tool (MUST) from the UK incorporates body mass index (BMI), weight loss for 3-6 months, and anorexia for five days due to diseases. It is particularly sensitive for recognition of protein energy under-nutrition among hospitalized patients. It has been modified and validated for local use as Hong Kong Chinese-MUST (HKC-MUST).
Nutrition screening using HKC-MUST in Yan Chai Hospital (YCH) has been initially implemented in medical and surgical wards with target patients, old age home residents (OAHR), since November 2012. It was then extended to all patients transferred to convalescence wards since 2015.
Objectives :
The study aimed to estimate the prevalence of malnutrition among patients screened by reviewing the implementation of nutrition screening in YCH from 2015 to 2019.
Methodology :
It comprised a retrospective study involving OAHR admitted to medical and surgical wards and all patients transferred to convalescence wards in YCH from 2015 to 2019. The outcome measures were percentage of malnourished patients screened, average BMI and average HKC-MUST score.
Result & Outcome :
Results From November 2015 to October 2019, 202 OAHRs were admitted to medical wards, 470 OAHRs admitted to surgical wards and 3289 patients transferred to convalescence wards were screened by HKC-MUST. The malnutrition prevalence (HKC-MUST score >=1) was 69.6 % (141), 32.6 % (153) and 38.1% (1254) respectively. The average BMI was 21(±4.1), 15.5(±4.5) and 16.9(±4.8) respectively. The average HKC-MUST score was 1.2(±1.1), 0.6(±0.9) and 0.4(±2.1) respectively. Conclusions Over 30% of the patients screened were malnourished. The highest rate of malnutrition was in OAHR admitted to medical wards (69.6 %). While OAHR admitted to surgical wards was with the lowest BMI (15.5) among those screened. Our review confirms that the older-old, e.g. OAHR, require extra consideration of their malnutrition risk. Implications for practice Malnutrition is a major burden for patients and healthcare professionals. It calls for increased awareness of healthcare professionals, hospital-wide nutrition screening and effective treatment to those who are malnourished.
