Vienna: For the first time in the world, an accurate analysis has been made of the eating habits of around 92,000 hospitalised patients in 56 different countries: the most serious risk factors for "not eating enough in hospital", and hence for increased mortality and morbidity, are the same everywhere – no matter whether in Europe or the USA. That was the central finding of a study conducted by researchers from MedUni Vienna’s Department of Anesthesia, Critical Care and Pain Medicine, the Department of Medicine III and the Center for Medical Statistics, Informatics and Intelligent Systems.
Inadequate food intake and malnourishment in sick people is an area
of concern for health policy and Public Health and one which impacts
upon the social economics of countries with both high and low incomes.
"Ensuring that patients receive adequate nutrition should therefore be
part of an holistic treatment plan," explains Karin Schindler,
nutritional expert at MedUni Vienna’s Department of Medicine III.
Morbidity and mortality rates are up to 8-times higher in malnourished
patients: in some cases this prolongs the time they need to spend in
hospital. Schindler: "On the other hand, we must bear in mind that 50 –
60% of patients do not eat all of a meal that is offered and this
reduced food intake is rarely offset by nutritional care."
Hospitalisation associated with a much smaller appetiteThe
researchers from MedUni Vienna have now investigated the factors (and
their pattern) that influence the food intake of patients on a specific
day, nutritionDay, and the healthcare structures that are relevant to
nutrition in 91,245 hospitalised patients throughout the world and have
published the results in the leading magazine "The American Journal of
The central finding: the factors of "reduced
mobility", "unintentional weight loss" and "patient has not eaten
enough over the previous week" signify an increased risk of eating less.
Women are more frequently affected than men and very young and very old
people more so than people aged between 40 and 79 years. These four
factors are practically of equal importance everywhere – even in the USA
where patients generally come into hospital with a higher Body Mass
Index. The pattern is always the same: illness goes hand-in-hand with a
Schindler: "If any one of these factors is
identified, alarm bells should ring." The eating patterns of these
patients should be monitored and they should be supervised and advised,
say the MedUni Vienna experts. "The excuse that patients often give that
"I am ill so I'm not eating," or even "that's good, at least I'm losing
weight" are not acceptable and are bad for their prognosis. These risk
groups need special attention."
This special attention must be
incorporated into the holistic treatment plan. Schindler: "Firstly
patients' eating behaviour should be systematically evaluated on
admission to hospital. The simple questions are quick to ask and easy to
answer. It should be explained to patients why it is important to eat.
It might also be worth considering structural adaptations, such as the
possibility of offering smaller portions or highly nutritious snacks
between meals or special individual meals. In addition to that, it can
be helpful to involve relatives in encouraging them to eat."
was instigated as a worldwide initiative, following a resolution in the
Council of Europe, and it takes place every year. Michael Hiesmayr,
Head of the Division of Cardiothoracic and Vascular Anesthesia and
Intensive Care Medicine at MedUni Vienna and Karin Schindler started
this action day 10 years ago. The next nutritionDay will take place on
10 November 2016.