Abstract
Background/Objectives:
Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies.
Subjects/Methods:
Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) <18.5 kg/m2 or significant weight loss (⩾10% in 3 months and/or ⩾5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected).
Results:
In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P<0.001).
Conclusion:
Present results confirm that in Italy, nutritional care routines are still poor and need improvements.
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Acknowledgements
This study was partially supported by unrestricted grants of Nutricia (Milan, Italy).
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Contributors: All the authors significantly contributed to the work, read and approved the final manuscript. LL, AD, MGG, NCB and MAF designed the study. AD and EC analysed the data. EC and CP wrote the manuscript. All the authors contributed to data interpretation and critical revision of the article.
Appendix
Appendix
We are particularly grateful to all contributing centres (the PIMAI group) and the relative personnel (nutritional scientists, dieticians and nurses) involved in data collection:
Dietetic and Clinical Nutrition Unit, Regional General Hospital Bolzano: L Lucchin, L Lando, S Borgo, GL Saffiotti.
Dietetic and Clinical Nutrition Unit, ‘Niguarda-Ca Granda’ Hospital, Milano: MG Gentile, E Rodeschini, LG Sandri.
Dietetic and Clinical Nutrition Unit, ‘Maggiore della Carità’ Hospital, Novara: F D’Andrea, M Brugnani, B Barbero, S Passera.
Dietetic and Clinical Nutrition Unit, University Hospital, Padova: L Caregaro, MT Nardi.
Dietetic and Clinical Nutrition Unit, ‘S Martino’ Hospital, Genova: GS Sukkar, C Ferrari.
Dietetic and Clinical Nutrition Unit, ‘Le Scotte’ University Hospital, Siena: R Mattei, A Grosso, C Francalanzi, F Cardinali, E Borsi.
Dietetic and Clinical Nutrition Unit, ‘Casa Sollievo della Sofferenza’ Hospital, S Giovanni Rotondo, Foggia: A Orban, L Cianti.
Endocrinology, Diabetology and Clinical Nutrition Unit, ‘S Sebastiano’ Hospital, Caserta: M Prilli, R Capriello, S Sorrentino, MR Pennino.
Dietetic and Clinical Nutrition Unit, ‘Canizzarro’ Hospital, Catania: F Leonardi, AME Bellino, EA Massimino.
Dietetic and Clinical Nutrition Unit, ‘Umberto I’ Hospital, Ancona: A Nicolai, M Petrelli, M Taus, D Busni, MG Borri, S Vitrini.
Dietetic and Clinical Nutrition Unit, ‘A Cardarelli’ Hospital, Campobasso: S Pastò, P Di Biase, R D’Onofrio, AM Di Brino, C Celi, V Mastronuzzi.
Department of Internal Medicine, University ‘La Sapienza’, Roma: M Muscaritoli, I Preziosa, A Canali.
Dietetic and Clinical Nutrition Unit, ‘S Maria’ Hospital, Terni: G Fatati, E Mirri, M Palazzi, AL Vendetti, S Sette, V Panetta.
National Institute for Research on Food and Nutrition (INRAN), Rome.
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Cereda, E., Lucchin, L., Pedrolli, C. et al. Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study. Eur J Clin Nutr 64, 894–898 (2010). https://doi.org/10.1038/ejcn.2010.85
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DOI: https://doi.org/10.1038/ejcn.2010.85