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  • Original Article
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Clinical nutrition, enteral and parenteral nutrition

Malnutrition risk in newly hospitalized overweight and obese individuals: Mr NOI

European Journal of Clinical Nutrition volume 67, pages 620–624 (2013)Cite this article

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Abstract

BACKGROUND/OBJECTIVES:

Malnutrition risk and its consequences have not been reported in obese and overweight newly hospitalized patients. To estimate malnutrition risk among newly hospitalized overweight or obese patients, and to assess the effect of body mass index (BMI) on duration of hospitalization and risk of in-hospital death among hospitalized adults at increased risk of malnutrition.

SUBJECTS/METHODS:

In this survey, all adults newly admitted to internal medicine and surgical departments at a large tertiary medical center, during the 5-week data acquisition period in 2010, were screened for malnutrition risk using the Nutrition Risk Screen (NRS 2002). Malnutrition risk was compared across body weight categories. In addition, overweight/obese subjects were compared by malnutrition risk category.

RESULTS:

Of the 431 individuals analyzed, 138 were overweight and 105 were obese. Among overweight or obese patients, 23.2% and 24.8%, respectively, were at increased risk for malnutrition. Elevated risk for malnutrition prolonged hospitalization for both overweight and obese patients (from 5.6±7.9 to 10.0±10.3 days (P=0.04) and from 4.8±4.6 to 15.1±25.7 days (P=0.001), respectively). Prolonged hospital stay remained associated with malnutrition risk after controlling for age and BMI. Malnutrition risk significantly increased odds of in-hospital death: odds ratio (OR) 6.4, 95% confidence interval (CI) 1.2–33.2, P=0.03, even after controlling for age and BMI.

CONCLUSIONS:

Increased malnutrition risk is a frequent finding in newly hospitalized overweight/obese adults, prolongs length of hospital stay and increases risk of in-hospital mortality.

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References

  1. Saunders J, Smith T . Malnutrition: causes and consequences. Clin Med 2010; 10: 624–627.

    Article  Google Scholar 

  2. Ramakrishnan U . Prevalence of micronutrient malnutrition worldwide. Nutr Rev 2002; 60: S46–S52.

    Article  Google Scholar 

  3. Correia MI, Campos AC . Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition 2003; 19: 823–825.

    Article  Google Scholar 

  4. Beghetto MG, Luft VC, Mello ED, Polanczyk CA . Accuracy of nutritional assessment tools for predicting adverse hospital outcomes. Nutr Hosp 2009; 24: 56–62.

    CAS  PubMed  Google Scholar 

  5. Gyres S, Leibovitz E, Matas Z, Fridman S, Gavish D, Shalev B et al. Measuring nutrition risk in hospitalized patients: MENU, a hospital-based prevalence survey. Isr Med Assoc J 2012; 14: 405–409.

    Google Scholar 

  6. Rüfenacht U, Rühlin M, Wegmann M, Imoberdorf R, Ballmer PE . Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients. Nutrition 2010; 26: 53–60.

    Article  Google Scholar 

  7. Goiburu ME, Goiburu MMJ, Bianco H, Díaz JR, Alderete F, Palacios MC et al. The impact of malnutrition on morbidity, mortality and length of hospital stay in trauma patients. Nutr Hosp 2006; 21: 604–610.

    CAS  PubMed  Google Scholar 

  8. Lawson RM, Doshi MK, Barton JR, Cobden I . The effect of unselected post-operative nutritional supplementation on nutritional status and clinical outcome of orthopaedic patients. Clin Nutr 2003; 22: 39–46.

    Article  CAS  Google Scholar 

  9. Rasmussen HH, Holst M, Kondrup J . Measuring nutrition risk in hospitals. Clin Epidemiol 2010; 2: 209–216.

    Article  Google Scholar 

  10. Song X, Pitkäniemi J, Gao W, Heine RJ, Pyörälä K, Söderberg S et al. Relationship between body mass index and mortality among Europeans. Eur J Clin Nutr 2011; 66: 156–165.

    Article  Google Scholar 

  11. Boggs DA, Rosenberg L, Cozier YC, Wise LA, Coogan PF, Ruiz-Narvaez EA et al. General and abdominal obesity and risk of death among black women. N Engl J Med 2011; 365: 901–908.

    Article  CAS  Google Scholar 

  12. Evans DC, Stawicki SP, Davido HT, Eiferman D . Obesity in trauma patients: correlations of body mass index with outcomes, injury patterns, and complications. Am Surg 2011; 77: 1003–1008.

    PubMed  Google Scholar 

  13. Gupta R, Knobel D, Gunabushanam V, Agaba E, Ritter G, Marini C et al. The effect of low body mass index on outcome in critically ill surgical patients. Nutr Clin Pract 2011; 26: 593–597.

    Article  Google Scholar 

  14. Hutagalung R, Marques J, Kobylka K, Zeidan M, Kabisch B, Brunkhorst F et al. The obesity paradox in surgical intensive care unit patients. Intens Care Med 2011; 37: 1793–1799.

    Article  Google Scholar 

  15. Weiss A, Beloosesky Y, Boaz M, Yalov A, Kornowski R, Grossman E . Body mass index is inversely related to mortality in elderly subjects. J Gen Intern Med 2008; 23: 19–24.

    Article  Google Scholar 

  16. Weiss A, Boaz M, Beloosesky Y, Kornowski R, Grossman E . Body mass index and risk of all-cause and cardiovascular mortality in hospitalized elderly patients with diabetes mellitus. Diabet Med 2009; 26: 253–259.

    Article  CAS  Google Scholar 

  17. Kondrup J, Rasmussen HH, Hamberg O, Stanga Z . Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr 2003; 22: 321–336.

    Article  Google Scholar 

  18. Friedwald WT, Levy RT, Fredrickson DS . Estimation of the concentration of low-density lipoprotein-cholesterol without the use of the preparation ultracentrifuge. Clin Chem 1972; 18: 499–502.

    Google Scholar 

  19. Hickson M, Frost G . A comparison of three methods for estimating height in the acutely ill elderly population. J Hum Nutr Diet 2003; 16: 13–20.

    Article  CAS  Google Scholar 

  20. Jung MY, Chan MS, Chow VSF, Chan YTT, Leung PF, Leung EMF et al. Estimating geriatric patient’s body weight using the knee height caliper and mid-arm circumference in Hong Kong Chinese. Asia Pac J Clin Nutr 2004; 13: 261–264.

    CAS  PubMed  Google Scholar 

  21. Kaidar-Person O, Person B, Szomstein S, Rosenthal RJ . Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins. Obes Surg 2008; 18: 870–876.

    Article  Google Scholar 

  22. Kaidar-Person O, Rosenthal RJ . Malnutrition in morbidly obese patients: fact or fiction? Miner Chir 2009; 64: 297–302.

    CAS  Google Scholar 

  23. Brody H, Hermer LD, Scott LD, Grumbles LL, Kutac JE, McCammon SD . Artificial nutrition and hydration: the evolution of ethics, evidence, and policy. J Gen Intern Med 2011; 26: 1053–1058.

    Article  Google Scholar 

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Authors and Affiliations

  1. Internal Medicine Department ‘A’, E Wolfson Medical Center, Holon, Israel

    E Leibovitz

  2. Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel

    S Giryes & M Zikri Ditch

  3. Department of Orthopedics, E Wolfson Medical Center, Holon, Israel

    R Makhline

  4. Management, E Wolfson Medical Center, Holon, Israel

    Y Berlovitz

  5. Epidemiology and Research Unit, E Wolfson Medical Center, Holon, Israel

    M Boaz

  6. Department of Nutrition, School of Health Sciences, Ariel University, Ariel, Israel

    M Boaz

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  1. E Leibovitz
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  2. S Giryes
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  4. M Zikri Ditch
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  5. Y Berlovitz
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  6. M Boaz
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Correspondence to M Boaz.

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Leibovitz, E., Giryes, S., Makhline, R. et al. Malnutrition risk in newly hospitalized overweight and obese individuals: Mr NOI. Eur J Clin Nutr 67, 620–624 (2013). https://doi.org/10.1038/ejcn.2013.45

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