Malnutrition risk in obese geriatric patients?

Peer-reviewed / Manuscript (overview) received: 16. July 2020 / Revision accepted: 03. December 2020

A routine data based analysis for patients living in nursing homes

Introduction

Malnutrition is still a common problem in hospitals. The latest data from the annual nutritionDay audit shows that 15.9% of patients in German hospitals are moderately and 21.5% severely malnourished [1]. Among geriatric patients in German-speaking areas, depending on the sample between 17% and 30% are malnourished and 38% to 65% display a risk of malnutrition [2]. This can sometimes be associated with extremely negative consequences. For instance, patients at risk of malnutrition suffer falls in hospital significantly more frequently [3], are hospitalised for longer [4], suffer more frequently from extreme fragility and functional impairments [5] and, regardless of age, die more often in hospital [6-8].

Despite this knowledge, the topics of nutrition and abnormalities in connection with eating habits and nutritional status are given little consideration in day-to-day hospital life [9, 10]. Consequently, there is chronic underestimation of the problem, those affected are not recognised and thus there is rarely nutritional intervention [1, 11].

Abstract

Weight loss and malnutrition represent significant problems for geriatric patients in hospital. Based on a secondary analysis of routine data from nursing homes, an investigation was carried out into the causes of ≥ 5% weight loss in obese geriatric patients during hospitalisation. The data came exclusively from patients living in nursing homes. Among patients with a BMI of ≥ 30 kg/m², 29.1% (n = 91; N = 281) lost at least 5% of their body weight, 28.4% (n = 98; N = 313) developed a new malnutrition risk in hospital. A logistic regression analysis showed that the risk of losing ≥ 5% body weight in hospital increased when in the previous three months there was no weight loss trend (OR 1.5; 95% CI 1.06–1.23), when there was a long period of hospitalisation (OR 1.10; 95% CI 1.06–1.15), with a secondary diagnosis of anaemia (OR 2.23; 95% CI 1.00–4.94) and with discharge diagnoses in the ICD-10 group of respiratory system diseases (OR 2.53; 95% CI 1.12–5.70).

Keywords: weight loss, malnutrition, geriatrics, nursing home, obesity

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