High prevalence of hospital malnutrition associated with poor clinical outcomes: Literature review

More than 60  per cent of the studies included in the analysis found that at least 40  per cent of the c

Hospital malnutrition is already documented in many observational studies from the US, Europe, and Latin America. A recently published literature review has now found that malnutrition is highly prevalent across different hospital patient groups in 11 countries in Asia.

As per the authors, Inciong J, Chaudhary A, Hsu H, et al in the study titled, Hospital malnutrition in northeast and southeast Asia: A systematic literature review, published in Clinical Nutrition ESPEN, more than 60  per cent of the studies included in the analysis found that at least 40  per cent of the patients were malnourished. The review also revealed that malnutrition is frequently linked to poor clinical outcomes and increased healthcare costs – bringing to light a critical unmet patient need within the region.

A significant association between poor nutrition status and an increased risk of clinical complications was also shown. Complications include infections, pressure ulcers, fractures, as well as pulmonary, renal and hepatic complications. Multiple studies found that malnutrition-related complications increased the length of hospital stay and the frequency of readmission. Moreover, malnutrition was linked to an increased risk of mortality. This is evident from 27 out of 28 studies evaluating the relationship between malnutrition and mortality in hospitalised patients.

Malnutrition increases healthcare costs

The detrimental effect of poor nutrition status on patient outcomes might take its toll on the health economic system of Asian countries. Two of the reviewed studies investigated the economic consequences of malnutrition, both found a clear association between hospital malnutrition and increased hospitalisation costs.

Medical experts of the review emphasise the need for further research aiming at optimising nutritional screening and management to fight malnutrition and its clinical and economic consequences in Asia.

The review is based on a systematic search for articles on hospital malnutrition in Asia published between January 1997 and January 2018. Articles reporting data on the prevalence, clinical consequences, or economic costs of hospital malnutrition in an adult inpatient population with a sample size >=30 were included in the analysis.

Based on these criteria, the review analysed a total of 92 studies with 62,280 patients in 11 Asian countries.

The complete literature review is available at http://www.unitedforclinicalnutrition.com.

Launched in 2015 by Fresenius Kabi, ‘United for clinical nutrition’ aims to overcome hospital malnutrition around the world. This multinational initiative seeks to reduce the prevalence of hospital malnutrition through regional data collection and clinical assessment, educational events and materials, and nutritional therapy support tools for healthcare professionals. In 2018, the initiative expanded in Asia with a special focus on surgical patients in India, Indonesia, Philippines, South Korea, Taiwan, Thailand, and Vietnam.