Nutritional care routines in Italy: results from the PIMAI (Project: Iatrogenic MAlnutrition in Italy) study.
OBJECTIVE
Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies.


METHODS
Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) <18.5 kg/m(2) or significant weight loss (>or=10% in 3 months and/or >or=5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected).


RESULTS
In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P<0.001).


CONCLUSIONS
Present results confirm that in Italy, nutritional care routines are still poor and need improvements.
Cereda
E
E
International Center for the Assessment of Nutritional Status (ICANS)-Dipartimento di Scienze e Tecnologie Alimentari e Microbiologiche (DISTAM), Università degli Studi di Milano, Milano, Italy. emanuele.cereda@virgilio.it
Lucchin
L
L
Pedrolli
C
C
D'Amicis
A
A
Gentile
M G
MG
Battistini
N C
NC
Fusco
M A
MA
Palmo
A
A
Muscaritoli
M
M
D000886:Anthropometry; D001291:Attitude of Health Personnel; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D002983:Clinical Competence; D015897:Comorbidity; D003695:Delivery of Health Care / Q000592:standards*; D002149:Energy Intake; D017408:Guidelines as Topic; D006760:Hospitalization; D006801:Humans; D007558:Italy / Q000453:epidemiology; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015596:Nutrition Assessment; D009749:Nutrition Surveys; D052756:Nutritional Sciences; D018529:Nutritional Support / Q000706:statistics & numerical data*; D018570:Risk Assessment; D015431:Weight Loss
D015415:Biomarkers