Research presented by BAPEN (The British Association for Parenteral and Enteral Nutrition) demonstrates that screening for malnutrition can pick up patients who are at risk but who are currently missed. It can also be used to predict hospital admissions and mortality.
“MUST screening is simple and quick to perform,” explained research co-ordinator, Dermot Burke, consultant colorectal surgeon. “Using MUST, high risk of malnutrition was identified in 33 patients (15%) but of these only six (18%) had seen a dietitian. Our study highlights that patients at risk of malnutrition are being missed by current screening methods.”
Afurther 361 outpatients at Guy’s and St Thomas Hospitals, London with chronic obstructive pulmonary disease were screened using a validated nutrition screening tool, based on the four questions considered by BAPEN to be the minimum required to identify at risk patients; that is, weight, height, recent unintentional weight loss and poor dietary intake. Patients were allocated to a nutrition risk category and followed up twelve months later for non-elective hospital admission, length of hospital stay and mortality (in hospital and the community).
“Our study demonstrated that both non-elective hospital admissions and length of hospital stay increased with the malnutrition risk category,” said research leader Dr Elizabeth Weekes. “Twelve-month mortality also progressively increased with malnutrition in 16% of high risk patients and 6% with low risk. This remained a significant result after controlling for the effect of age. This study shows that a nutrition screening tool based on BMI, unintentional weight change and poor dietary intake can predict outcome in outpatients with chronic respiratory disease.”
The purpose of screening is to ensure that all patients who are malnourished, or at risk of becoming malnourished, are identified on admission to hospital and an appropriate nutrition care plan put in place in order to effect better patient experience and outcomes.
