Waitzberg Dan Linetzky, De Aguilar-Nascimento José Eduardo, Dias Maria Carolina Gonçalves, Pinho Nivaldo, Moura Robson, Correia Maria Isabel Toulson Davisson
University of Sao Paulo, School of Medicine.
Nutr Hosp. 2017 Jul 28;34(4):969-975. doi: 10.20960/nh.1098.
Malnutrition in hospitalized patients is not evaluated frequently. However, it is a critical issue given that it has been related to a high rate of infectious complications and increased mortality rates. There is a high prevalence of patients with nutritional impairment in the home environment, which favors their clinical worsening, the increase of re-hospitalizations and, consequently, the increase in public health expenditures.
Nutrition experts have thoroughly discussed and written this positioning paper on hospital and homecare malnutrition to describe the prevalence of malnutrition in Brazil. Best practice recommendations for nutrition therapy of patients in hospital and homecare, in particular the use of oral nutritional supplements (ONS), to those who are at risk of malnutrition or malnourished were evaluated, and the impact on clinical and economic data were assessed. In addition, they emphasize that investments in oral nutritional supplementation are also important in the homecare environment (home or nursing homes).
Selected scientific articles on disease-related malnutrition, especially those carried out in Brazil, were assessed. Data on prevalence, clinical outcomes, and economic burdens were reviewed.
Several studies have shown the importance of in-hospital nutritional assessment for early detection of malnutrition and early intervention with nutrition therapy, in particular with oral nutritional therapy. Unfortunately, hospital malnutrition remains high in Brazil, with severe consequences for patients. The implementation of universal nutritional screening and diagnosis as well as the therapeutic approach of malnutrition, particularly with the use, when possible, of oral nutrition supplements as the first step to address this condition is still low, and demands the investment in educational resources to change practices. Routine use of nutritional therapy in hospital and homecare settings improves clinical outcomes, is cost effective, and would be expected to help reduce healthcare costs.
住院患者的营养不良情况未得到频繁评估。然而，鉴于其与高感染并发症发生率和死亡率增加相关，这是一个关键问题。在家庭环境中，营养受损患者的患病率很高，这有利于他们的病情恶化、再住院率增加，进而导致公共卫生支出增加。
营养专家就医院和家庭护理中的营养不良问题深入讨论并撰写了本立场文件，以描述巴西营养不良的患病率。评估了针对医院和家庭护理中营养不良或有营养不良风险患者的营养治疗最佳实践建议，特别是口服营养补充剂（ONS）的使用，并评估了其对临床和经济数据的影响。此外，他们强调在家庭护理环境（家庭或养老院）中对口服营养补充的投资也很重要。
评估了关于疾病相关营养不良的精选科学文章，特别是在巴西开展的那些研究。回顾了关于患病率、临床结果和经济负担的数据。
多项研究表明，医院营养评估对于早期发现营养不良以及早期进行营养治疗干预，特别是口服营养治疗具有重要意义。不幸的是，巴西医院营养不良的情况仍然很严重，给患者带来了严重后果。普遍营养筛查和诊断以及营养不良治疗方法的实施，特别是在可能的情况下将口服营养补充剂作为解决该问题的第一步的应用仍然很少，这需要对教育资源进行投资以改变实践。在医院和家庭护理环境中常规使用营养治疗可改善临床结果，具有成本效益，并有望帮助降低医疗成本。
