Frontier Innovators Global, Lilongwe, Malawi.
Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA, 93407, USA.
Eur J Clin Nutr. 2022 Aug;76(8):1158-1164. doi: 10.1038/s41430-022-01087-5. Epub 2022 Feb 2.
BACKGROUND/OBJECTIVES: In Africa, approximately two-thirds of patients are at risk of malnutrition on admission and the nutritional status of patients deteriorates during hospitalization, with associated increased morbidity, mortality, and hospital-related cost. This cross-sectional study aimed at estimating rates of malnutrition in critical care units and determining the extent to which malnutrition diagnoses are documented in medical records by physicians, at two public tertiary hospitals in Malawi.
A total of 315 adult (n = 112) and paediatric (n = 203) participants from Queen Elizabeth Central Hospital and Kamuzu Central Hospital, were included in the analysis. Nutrition status was measured by Subjective Global Assessment (SGA) and Mid-Upper Arm circumference (MUAC) and medical notes were reviewed, in both adults and paediatrics.
In adults, more than half were malnourished, with a higher proportion considered moderately-to-severely malnourished using SGA compared to MUAC (84.8%; 57.3%, respectively). Likewise, in paediatrics, a higher proportion was considered moderately-to-severely malnourished using SGA compared to MUAC (84.7%; 23.4%, respectively). Both adult and paediatric patients with cancer had the highest rates of malnutrition. Only 12.9% and 9.6% had documentation of malnutrition diagnosis in the medical record, for paediatrics and adult patients, respectively.
The high rates of hospital malnutrition in critically ill patients in Malawi call for comprehensive screening practices and methods; complemented by documentation of the malnutrition diagnosis and use of nutrition interventions by dietitians. This includes enteral, parenteral and supplemental nutrition as a prerequisite for patient recovery in hospitals.
背景/目的：在非洲，大约三分之二的患者入院时存在营养不良风险，并且患者的营养状况在住院期间恶化，导致发病率、死亡率和与医院相关的费用增加。本横断面研究旨在评估重症监护病房的营养不良发生率，并确定在马拉维的两家公立三级医院，医生在病历中记录营养不良诊断的程度。
共纳入来自伊丽莎白女王中央医院和卡姆祖中央医院的 315 名成年（n=112）和儿科（n=203）患者。营养状况通过主观整体评估（SGA）和上臂中部周长（MUAC）进行测量，并对成年和儿科患者的医疗记录进行了审查。
在成年人中，超过一半的人存在营养不良，使用 SGA 评估的中度至重度营养不良比例高于 MUAC（分别为 84.8%和 57.3%）。同样，儿科患者中，使用 SGA 评估的中度至重度营养不良比例高于 MUAC（分别为 84.7%和 23.4%）。癌症患者在成年和儿科患者中均有最高的营养不良发生率。只有 12.9%和 9.6%的儿科和成年患者的病历中有营养不良诊断的记录。
马拉维重症监护病房危重症患者的高营养不良发生率需要全面的筛查实践和方法；通过营养师记录营养不良诊断和使用营养干预措施来补充。这包括肠内、肠外和补充营养，作为患者在医院康复的前提条件。
