Malnutrition in hospitalized geriatric patients

Abstract

The incidence of hospital malnutrition has not been systematically studied in Hong Kong hospitals. This study was initiated to determine if malnutrition in geriatric patients is being under reported and to evaluate the efficacy of a modified monitoring and reporting procedure. Subjects (>65 yr) on congee or enteral diet were medically stable. In the control phase (3 months), newly admitted patients received standard hospital care and 9 out of 67 (13%) were identified as malnourished (CM). The study phase started one month after the last control subject was recruited. Plasma albumin (ALB) <28 g/l and the presence of diarrhea were used as criteria in identifying the malnourished (SM). 16 out of 51 (31%) newly admitted patients were SM. At identification, ALB levels were low (19.5 g/l) but similar between CM & SM. Prealbumin (PA) levels of the SM, however, were higher than that of the CM (0.117 vs 0.087 g/l, p<0.05). A similar trend was observed for plasma transferrin (TRF) (1.34 vs 1.03 g/l, p=0.07). Upon three weeks of nutritional intervention, PA levels were increased by 56% and 66% in the CM and SM, respectively. TRF levels were also increased significantly by 32% and 19%. These data suggest that malnutrition in geriatric patients is a serious problem. A routine but effective procedure should be enforced for early detection and intervention.