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http://dx.doi.org/10.14373/JKDA.2014.20.4.285

Changes in Nutrient Intake in Patients at Nutritional Risk  

Lee, Ho Sun (Dept. of Nutrition and Dietetics, Severance Hospital, Yonsei University Health System)
Shin, Kyung Hun (Dept. of Nutrition and Dietetics, Severance Hospital, Yonsei University Health System)
Rha, Sun Young (Dept. of Internal Medicine, Yonsei University College of Medicine)
Chung, Moon Jae (Dept. of Internal Medicine, Yonsei University College of Medicine)
Song, Si Young (Dept. of Internal Medicine, Yonsei University College of Medicine)
Song, Seung Eun (Dept. of Nutrition and Dietetics, Severance Hospital, Yonsei University Health System)
Ham, Hye Jin (Dept. of Nutrition and Dietetics, Severance Hospital, Yonsei University Health System)
Kim, Hyung Mi (Dept. of Nutrition and Dietetics, Severance Hospital, Yonsei University Health System)
Publication Information
Journal of the Korean Dietetic Association / v.20, no.4, 2014 , pp. 285-295 More about this Journal
Abstract
The purpose of this study was to examine changes in nutrient intake in patients at nutritional risk. We included 106 malnourished patients who were admitted to Severance Hospital from March to September 2014. The average age was $59.0{\pm}11.6$ years old and 59 patients were male (59.7%). The majority of diagnosis was cancer (94.3%). We evaluated patients' nutritional status by scored patient-generated subjective global assessment (PG-SGA), anthropometric measurement (height, weight, body composition by Bioelectrical impedance analysis), hand grip strength, biochemical and dietary assessment. The patients' daily intakes of energy and protein ($1,019.5{\pm}706.4kcal$, $40.4{\pm}27.7g$) during hospitalization were significantly lower than their usual intakes ($1,382.0{\pm}499.8kcal$, $54.4{\pm}25.1g$, P<0.001). Serum levels of albumin, cholesterol, and total lymphocytes were significantly reduced during hospital stay. The negatively influencing factors for reduced dietary intake were anorexia (42.5%), abdominal distention (14.2%), pain (13.2%), and others. The results of this study could be used to establish baseline data for developing new strategies for nutritional intervention in malnourished patients.
Keywords
malnutrition; patient; energy; protein; intervention;
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1 Allison SP (2000): Malnutrition, disease, and outcome. Nutrition 16(7-8):590-593   DOI   ScienceOn
2 Amaral TF, Matos LC, Teixeira MA, Tavares MM, Alvares L, Antunes A (2010): Undernutrition and associated factors among hospitalized patients. Clin Nutr 29(5):580-585   DOI
3 Bauer J, Capra S, Ferguson M (2002): Use of the scored Patient-Generated Subjective Global Assessment (PG-SGA) as a nutrition assessment tool in patients with cancer. Eur J Clin Nutr 56(8):779-785   DOI   ScienceOn
4 Binnekade JM, Tepaske R, Bruynzeel P, Mathus-Vliegen EM, de Hann RJ (2005): Daily enteral feeding practice on the ICU: attainment of goals and interfering factors. Crit Care 9(3):R218-R225   DOI
5 Bistrian BR, Blackburn GL, Hallowell E, Heddle R (1974): Protein status of general surgical patients. JAMA 230(6): 858-860   DOI
6 Bozzetti F, Arends J, Lundholm K, Micklewright A, Zurcher G, Muscaritoli M (2009): ESPEN Guidelines on Parenteral Nutrition: non-surgical oncology. Clin Nutr 28(4):445-454   DOI   ScienceOn
7 Bozzetti F, Gavazzi C, Miceli R, Rossi N, Mariani L, Cozzaglio L, Bonfanti G, Piacenza S (2000): Perioperative total parenteral nutrition in malnourished, gastrointestinal cancer patients: a randomized, clinical trial. JPEN J Parenter Enteral Nutr 24(1):7-14   DOI
8 Burt ME, Gorschboth CM, Brennan MF (1982): A controlled, prospective, randomized trial evaluating the metabolic effects of enteral and parenteral nutrition in the cancer patient. Cancer 49(6):1092-1105   DOI
9 Chung SH, Sohn CM (2005): Nutritional status of hospitalized geriatric patients using by the mini nutritional assessment. Korean J Community Nutr 10(5):645-653   과학기술학회마을
10 Correia MI, Waitzberg DL (2003): The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 22(3):235-239   DOI   ScienceOn
11 De Cicco M, Panarello G, Fantin D, Veronesi A, Pinto A, Zagonel V, Monfardini S, Testa V (1993): Parenteral nutrition in cancer patients receiving chemotherapy: effects on toxicity and nutritional status. JPEN J Parenter Enteral Nutr 17(6):513-518   DOI   ScienceOn
12 de Oliveira MR, Leandro-Merhi VA (2011): Food intake and nutritional status of hospitalised older people. Int J Older People Nurs 6(3):196-200   DOI
13 Duran Alert P, Mila Villarroel R, Formiga F, Virgili Casas N, Vilarasau Farre C (2012): Assessing risk screening methods of malnutrition in geriatric patients: Mini Nutritional Assessment (MNA) versus Geriatric Nutritional Risk Index (GNRI). Nutr Hosp 27(2):590-598
14 Delmi M, Rapin CH, Bengoa JM, Delmas PD, Vasey H, Bonjour JP (1990): Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 335(8696):1013-1016   DOI   ScienceOn
15 Drott C, Unsgaard B, Scherstén T, Lundholm K (1988): Total parenteral nutrition as an adjuvant to patients undergoing chemotherapy for testicular carcinoma: protection of body composition-a randomized, prospective study. Surgery 103(5):499-506
16 Duerksen DR, Ting E, Thomson P, McCurdy K, Linscer J, Larsen-Celhar S, Brennenstuhl E (2004): Is there a role for TPN in terminally ill patients with bowel obstruction? Nutrition 20(9):760-763   DOI
17 Han JS, Lee SM, Chung HK, Ahn HS, Lee SM (2009): Development and evaluation of a nutritional risk screening tool (NRST) for hospitalized patients. Korean J Nutr 42(2):119-127   과학기술학회마을   DOI
18 Kinsella TJ, Malcolm AW, Bothe A Jr, Valerio D, Blackburn GL (1981): Prospective study of nutritional support during pelvic irradiation. Int J Radiat Oncol Biol Phys 7(4):543-548   DOI
19 Hur H (2013): Nutrition screening and assessment of patients for malnutrition. JKSPEN 5(1):1-8
20 Kim S, Kim S, Sohn C (2006): Development of nutrition screening index for hospitalized patients. Korean J Community Nutr 11(6):779-784   과학기술학회마을
21 Laura E, Laura LM, Paula DM, Barbara G (2006): The clinical guide to oncology nutrition. 2nd ed. American Dietetic Association. Chicago. pp.57-60
22 Lee H, Kang JH, Kim E, Kim WG (2014): Prevalence of malnutrition in hospitalized elderly Korean patients based on mini nutritional assessment-short form. JCN 6(1):24-29
23 Nieuwenhuizen WF, Weenen H, Rigby P, Hetherington MM (2010): Older adults and patients in need of nutritional support: review of current treatment options and factors influencing nutritional intake. Clin Nutr 29(2):160-169   DOI   ScienceOn
24 Lee HS, Shim HJ, Jang JY, Jung AR, Kim SH, Kim HM, Kim KS, Lee JG (2013): Development of a new nutrition screening tool for use in an acute care hospital. JKSPEN 2013;5(2):82-88
25 Lipkin EW, Bell S (1993): Assessment of nutritional status. The clinician's perspective. Clin Lab Med 13(2):329-352
26 Mueller CM, McClave S, Kuhn JM (2012): The ASPEN adult nutrition support core curriculum. American Society for Parenteral and Enteral Nutrition. Maryland (MD). pp.163
27 Olin AO, Osterberg P, Hadell K, Armyr I, Jerstrom S, Ljungqvist O (1996): Energy-enriched hospital food to improve energy intake in elderly patients. JPEN J Parenter Enteral Nutr 20(2):93-97   DOI
28 Nixon DW, Lawson DH, Kutner M, Ansley J, Schwarz M, Heymsfield S, Chawla R, Cartwright TH, Rudman D (1981): Hyperalimentation of the cancer patient with protein-calorie undernutrition. Cancer Res 41(6):2038-2045
29 Norman K, Pichard C, Lochs H, Pirlich M (2008): Prognostic impact of disease-related malnutrition. Clin Nutr 27(1):5-15   DOI   ScienceOn
30 Norman K, Stobaus N, Gonzalez MC, Schulzke JD, Pirlich M (2011): Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr 30(2):135-142   DOI   ScienceOn
31 Ottery FD (1994): Rethinking nutritional support of the cancer patient: the new field of nutritional oncology. Semin Oncol 21(6):770-778
32 Patel MD, Martin FC (2008): Why don't elderly hospital inpatients eat adequately? J Nutr Health Aging 12(4):227-231   DOI
33 Smith RC, Hartemink R (1988): Improvement of nutritional measures during preoperative parenteral nutrition in patients selected by the prognostic nutritional index: a randomized controlled trial. JPEN J Parenter Enteral Nutr 12(6):587-591   DOI
34 Sasaki H, Kasagi F, Yamada M, Fujita S (2007): Grip strength predicts cause-specific mortality in middle-aged and elderly persons. Am J Med 120(4):337-342   DOI   ScienceOn
35 Shamberger RC, Brennan MF, Goodgame JT Jr, Lowry SF, Maher MM, Wesley RA, Pizzo PA (1984): A prospective, randomized study of adjuvant parenteral nutrition in the treatment of sarcomas: results of metabolic and survival studies. Surgery 96(1):1-13
36 Uster A, Ruefenacht U, Ruehlin M, Pless M, Siano M, Haefner M, Imoberdorf R, Ballmer PE (2013): Influence of a nutritional intervention on dietary intake and quality of life in cancer patients: a randomized controlled trial. Nutrition 29(11-12):1342-1349   DOI
37 Shike M, Russel DM, Detsky AS, Harrison JE, McNeill KG, Shepherd FA, Feld R, Evans WK, Jeejeebhoy KN (1984): Changes in body composition in patients with small-cell lung cancer. The effect of total parenteral nutrition as an adjunct to chemotherapy. Ann Intern Med 101(3):303-309   DOI
38 Sullivan DH, Sun S, Walls RC (1999): Protein-energy undernutrition among elderly hospitalized patients: a prospective study. JAMA 281(21):2013-2019   DOI   ScienceOn
39 Torelli GF, Campos AC, Meguid MM (1999): Use of TPN in terminally ill cancer patients. Nutrition 15(9):665-667   DOI
40 White JV, Guenter P, Jensen G, Malone A, Schofield M (2012): Consensus statement: Academy of Nutrition and Dietetics and American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). JPEN J Parenter Enteral Nutr 36(3):275-283   DOI
41 Agarwal E, Ferguson M, Banks M, Bauer J, Capra S, Isenring E (2012): Nutritional status and dietary intake of acute care patients: results from the Nutrition Care Day Survey 2010. Clin Nutr 31(1):41-47   DOI   ScienceOn
42 Thibault R, Chikhi M, Clerc A, Darmon P, Chopard P, Genton L, Kossovsky MP, Pichard C (2011): Assessment of food intake in hospitalised patients: a 10-year comparative study of a prospective hospital survey. Clin Nutr 30(3):289-296   DOI