[New procedure for the early detection and control of hospital malnutrition].
The serious problem of hospital undernutrition is still being underestimated by medical staff of modern hospitals, despite its impact on clinical evolution and hospitalisation costs. The actual system used to detect undernutrition in hospitals depends on doctor's sensitivity and not even the 10% of the cases that require intervention are detected. The screening methods developed so far are not useful for daily clinical practice due to their low effectiveness/cost ratio. We present a screening method that allows an automatic daily assessment of nutritional status, of all inpatients that undergo routine analysis. The system is based on a computer application that compiles daily all patients' information available in hospital databases, through the internal network. It automatically assesses the nutritional status of patients taking into account laboratory information concerning albumin, total cholesterol and total lymphocyte count. This tool also provides diagnostic and patients data for physicians' usage. The screening method has been validated, obtaining a sensitivity of 92.3 and specificity of 85.0, considering only laboratory information. This is an efficient tool for early detection and permanent control of hospital undernutrition, with the suitable characteristics for these screening functions, such as its sensitivity, specificity, universality, economy and harmlessness, as well as a great versatility for undertaking a high number of studies regarding the hospital undernutrition problem. We trust that working with it we will obtain a remarkable welfare improvement as well as make aware to people in charge of Public Health of the magnitude of the undernutrition's derived consequences of hospital's in-patients, and after discharge.
de Ulíbarri Pérez
J I
JI
Sección de Nutrición Clínica y Dietética, Hospital Universitario de La Princesa, Diego de León, 62, 28006 Madrid. julibarri@hlpr.insalud.es
González-Madroño Giménez
A
A
González Pérez
P
P
Fernández
G
G
Rodríguez Salvanés
F
F
Mancha Alvarez-Estrada
A
A
Díaz
A
A
D000328:Adult; D000368:Aged; D015415:Biomarkers; D002784:Cholesterol / Q000097:blood; D003195:Computer Communication Networks; D016208:Databases, Factual; D003936:Diagnosis, Computer-Assisted; D004573:Electrolytes / Q000097:blood; D005260:Female; D005521:Food Service, Hospital / Q000458:organization & administration; D006748:Hospital Departments / Q000706:statistics & numerical data; D006801:Humans; D007297:Inpatients; D018655:Lymphocyte Count; D008297:Male; D008403:Mass Screening / Q000379:methods*; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000097:blood / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis
D015415:Biomarkers; D004573:Electrolytes; D012709:Serum Albumin; D002784:Cholesterol