More than one in three patients malnourished on admission to hospital, new survey reveals

More than one in three patients, including older groups and people with cancer, are malnourished on admission to hospital and levels are rising, a new survey by nutrition experts has revealed.

The findings from 3,662 patients surveyed across 26 public hospitals in Ireland, showed an increase in patients suffering malnutrition; rising to 34pc, up from 32pc in 2011 and 28pc in 2010.

It was carried out by the the Irish Society for Clinical Nutrition and Metabolism (IrSPEN), which is calling for more patients to be screened for malnutrition.

Malnutrition rates had fallen in patients in long-stay or rehabilitation wards, at 21pc compared to 36pc on all other wards, and also in those admitted from other hospitals rather than from home, at 26pc versus to 35pc.

It said this highlighted how mandatory national malnutrition screening and treatment protocols introduced in public hospitals in 2020 are having a positive impact. However, IrSPEN said malnutrition screening should be expanded to other clinical settings such as outpatients, day-care and primary-care settings, particularly for cancer patients and frail, older people.

Survey co-author and IrSPEN director Niamh Rice said the survey identified two major reasons for the rise in patients with risk factors for malnutrition.

“The first is an increase in the age demographic of patients presenting at hospitals, with older people more likely to be malnourished, and secondly, a higher incidence of cancer, resulting in more cancer patients within the general hospital population – 22pc in November 2023 versus 16pc in 2011.This patient cohort is also more likely to suffer nutritional problems resulting in malnutrition,” she said.

“The level of malnutrition presenting at our public hospitals remains too high and some is preventable if we pay more attention to improving the nutritional status of patients in the community.

“We need to expand screening and treatment for malnutrition to all settings where cancer patients receive care, particularly in day wards where they receive systemic anti-cancer therapy (SACT), to facilitate rapid access to specialist cancer dietitians, of whom we have just a handful across the country.

“A secondary recommendation is to resource an expansion of targeted malnutrition screening and treatment for older people living with frailty, particularly those living alone and requiring home-care support.

“These patients typically present to their GP and to hospital emergency departments more frequently, and at significant cost to the healthcare system, due to falls and an increasing need for care.”

Cancer research dietitian Dr Erin Stella Sullivan said: “It is often incorrectly thought of as meaning being underweight or ‘skinny’. However, if patients are not eating what they need during illness, muscle is broken down in an attempt to keep the tissues supplied with the protein building blocks needed to keep everything functioning normally.

“The effect of a screening and treatment programme is that patients who are losing weight or failing to eat sufficient protein, energy or other nutrients, which are typically required in higher amounts during illness, are identified early.”

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